• Anne Marie Toomey, Fiona Leahy, Helen Purtill, Norma O'Brien, Emer O'Donovan, Zeeshan Ahmed, Mekki Medani, Tony Moloney, and Eamon G Kavanagh.
• School of Medicine, University of Limerick, Co. Limerick, V94 T9PX, Limerick, Ireland. annemarie.toomey1@gmail.com.
• Ir J Med Sci. 2025 Feb 6.

BackgroundThe prevalence of peripheral arterial disease (PAD) is increasing globally. An increase in PAD in an ageing population inevitably results in an increase in incidence of Chronic Limb Threatening Ischemia (CLTI). Loss of a limb is a life-changing event with immeasurable cost to the individual, while the potential financial benefit of saving a limb is not well documented.AimsThe focus of this study was to estimate the cost associated with surgical interventions used in the treatment of CLTI compared with amputation.MethodsThe cost to treat a CLTI diagnosis in 124 patients was analysed in an acute tertiary referral hospital over a 13-month study period. The analysis included staffing, medical devices used, number of blood components used and the length of stay. Statistical methods included descriptive statistical data and the Mann-Whitney U test.ResultsThe median cost, associated with length of stay, post-amputation and post-revascularisation (hybrid) was €61,313 [IQR = €44,417, €83,331] and €46,573 [IQR = €25,687, €58,554] respectively, p < 0.001. The total median cost for length of stay for amputees in an acute hospital, rehabilitation and a prosthetic limb was €88,820 [IQR = €74,486, €110,248]. The median surgical cost of an amputation was €2,064 [IQR = €1,342, €2,866], whilst the median surgical cost of a revascularisation procedure (hybrid) was €5,966 [IQR = €4,380, €7,723], p < 0.001, inclusive of total blood components transfused.ConclusionRevascularisation surgical interventions are more expensive than amputation, however, the length of stay, rehabilitation and prosthetic limb costs, for a patient undergoing a major limb amputation, is significantly more costly.© 2025. The Author(s).

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