"Wound to Amputation" — How Insurance Companies Are Dictating the Clinical Care of Chronic Limb-Threatening Ischemia

From Salvageable to Non-Salvageable Limb

Ivana Dilip Kumar, Research Associate¹; Anshita Kumari, MBBS²; Kusum Lata, MD, FACC, FSCAI³

¹Research Associate, Sutter Health, Tracy, California (Under Sutter Health Modesto, California); Quarry Lane School, Dublin, California; ²Kasturba Medical College, Manipal, India; Research Associate, Sutter Health Tracy, California (Under Sutter Health Modesto, California); ³Interventional Cardiology; Board of Trustees, SCAI; Sutter Health, Tracy, California (Under Sutter Health Modesto, California)

Kumar et al report how insurance denials and delays stalled tibial/pedal CLTI revascularization until a salvageable wound became a threatened limb-loss case, and outline what interventionalists can do to push care forward.

Who Owns the Limb? Ethical Boundaries of Insurance Control Over Medical Decisions

Anamika Fnu, MD; Sakshi Dixit, MD; Anmol Multani, MD; Akiva Rosenzveig, MD; Aravinda Nanjundappa, MD

Cleveland Clinic, Cleveland, Ohio

Fnu et al examine how insurer-driven approvals can shape (and sometimes constrain) limb-salvage decision-making, and argue for clearer ethical boundaries that keep clinical judgment and patient goals at the center of care.