Recommendations	Grade	Level of evidence	Key references
6.33	Offer endovascular revascularization when technically feasible for high-risk patients with advanced limb threat (eg, WIfI stage 4) and significant perfusion deficits (eg, WIfI ischemia grades 2 and 3).	2 (Weak)	C (Low)	Abu Dabrh,5 2015 Zhan,69 2015 Causey,70 2016 Darling,71 2016 Robinson,72 2017
6.34	Consider endovascular revascularization for high-risk patients with intermediate limb threat (eg, WIfI stages 2 and 3) and significant perfusion deficits (eg, WIfI ischemia grades 2 and 3).	2 (Weak)	C (Low)
6.35	Consider endovascular revascularization for high-risk patients with advanced limb threat (eg, WIfI stage 4) and moderate ischemia (eg, WIfI ischemia grade 1) if the wound progresses or fails to reduce in size by ≥50% within 4 weeks despite appropriate infection control, wound care, and offloading, when technically feasible.	2 (Weak)	C (Low)
6.36	Consider endovascular revascularization for high-risk patients with intermediate limb threat (eg, WIfI stages 2 and 3) and moderate ischemia (eg, WIfI ischemia grade 1) if the wound progresses or fails to reduce in size by ≥50% within 4 weeks despite appropriate infection control, wound care, and offloading, when technically feasible.	2 (Weak)	C (Low)
6.37	Consider open surgery in selected high-risk patients with advanced limb threat (eg, WIfI stage 3 or 4), significant perfusion deficits (ischemia grade 2 or 3), and advanced complexity of disease (eg, GLASS stage III) or after prior failed endovascular attempts and unresolved symptoms of CLTI.	2 (Weak)	C (Low)