The Basics of Treating CLI and Routine Use of IVUS


Join The PVD Channel for an exclusive 2-part episode as Drs. Steven Kum and Prakash Krishnan set the stage for optimal care of your patients with critical limb ischemia (CLI), including the important role of Intravascular Ultrasound (IVUS).

Part I: The Basics of Treating CLI - A Personal Approach

The PVD Channel welcomes Dr. Steven Kum for a foundational review of the essentials of optimal management in patients with chronic limb ischemia. From basic understanding of the disease state to the importance of diagnostic testing and the nuances of appropriate candidate selection, Dr. Kum provides a global perspective into the challenges and available solutions that can help you improve your patients’ outcomes through proper identification, analysis, risk assessment, preparation, and intervention.

Part II: Routine Use of IVUS in Planning Your CLI Case

As this episode continues, The PVD Channel further examines the role of Intravascular Ultrasound in the management of chronic limb ischemia and other common vascular disease states. Dr. Prakash Krishnan opens his case book to share real-world results, highlighting the importance of appropriate imaging selection for optimal patient outcomes. Learn why angiography alone is insufficient as Dr. Krishnan details the benefits and disadvantages of angiography and IVUS at each step of treatment.

Learning Objectives

After completing this activity, the participant should be better able to:

  • Identify the signs and symptoms of critical limb ischemia
  • Recognize disease severity and patient risk factors to optimize management plan
  • Describe how IVUS can assist in appropriate therapy selection
  • Discuss how to evaluate imaging results to determine whether open or endovascular revascularization is warranted

Target Audience

The educational design of this activity addresses the needs of Interventional Radiologists, Vascular Surgeons, Vascular Specialists, Nurse Practitioners, Radiologic Technologists, and Vascular Allied Health Professionals involved in the treatment of patients with peripheral vascular disease.

Prakash Krishnan, MD, FACC, FSCAI

Prakash Krishnan, MD, FACC, FSCAI

Interventional Cardiologist
Associate Professor of Medicine – Cardiology and Radiology
Icahn School of Medicine at Mount Sinai
Mount Sinai Health System
New York, NY, USA

Dr. Prakash Krishnan is an expert in peripheral vascular disease and is internationally recognized as a leader in the catheter-based treatment of coronary artery disease and peripheral arterial disease. Dr. Krishnan’s expertise includes nonsurgical treatment of coronary and peripheral vascular diseases including coronary stents, peripheral vascular angioplasty and stents, atherectomy, carotid stents, renal stents, renal denervation and complex venous disease intervention.

Dr. Krishnan is the System Director of Endovascular Services at the Mount Sinai Health System and Director of the Endovascular Intervention Fellowship in the Cardiac Catheterization Laboratory.

Dr. Krishnan was the Co-National Primary Investigator in the ILLUMENATE Trial, a multicenter randomized control study evaluating the safety and efficacy of the Stellarex drug-coated balloon in femoropopliteal lesions. He has received numerous awards and honors. He has authored numerous peer-reviewed articles and book chapters on peripheral arterial disease and is the Director of the NY Endovascular Summit, formerly LINC Mount Sinai Endovascular Symposium, an Icahn School of Medicine at Mount Sinai and Cardiovascular Institute-supported program, and Director of Mount Sinai’s Live Peripheral Interventions webcast series.



Vascular and Endovascular Surgeon
Mount Elizabeth Novena Hospital
Changi General Hospital

Dr. Steven Kum is a Vascular, Endovascular and General Surgeon at Mount Elizabeth Novena Hospital and Changi General Hospital, Singapore.

Dr. Kum received his medical degree from the National University of Singapore in 2000 and subsequently embarked on his surgical training with the Royal College of Surgeons, obtaining his Master of Medicine and Fellowship in 2007.

In 2009, Dr. Kum completed his postgraduate fellowship in Vascular and Endovascular Surgery at the Prince of Wales Hospital, Sydney as well as at the Department of Angiology at the Leipzig Heart Center. In 2012, he completed a second fellowship on advanced techniques in diabetic limb salvage and wound care techniques at the Universita Vita Salute San Raffaele, Milan.

Since 2015, Dr. Kum has been the Director of Vascular Surgery in the Department of Surgery at Changi General Hospital and he was subsequently appointed as a visiting consultant in 2019.

A clinical lecturer in both the NUS Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine in Singapore, Dr. Kum also serves as a faculty member for general surgical residents for SingHealth.

Dr. Kum regularly proctors physicians in endovascular procedures in Europe and Asia. He is frequently invited to several regional and international meetings and is part of the organizing committee of LINC and VERVE.

Dr. Kum has a keen interest in clinical research revolving around diabetic limb salvage. He is proficient in percutaneous deep arterialization for no-option critical limb ischemia, on which he has authored or co-authored numerous papers.

Dr. Kum is the principal investigator or co-PI for several industry- and physician-led studies, and is a keen innovator who is currently working on several revolutionary technologies.

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Educational Awareness Solutions. Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM MOC Recognition Statement

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 medical knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Nurse Practitioner Continuing Education

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of Global Education Group and Educational Awareness Solutions. Global Education Group is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 110121. This activity is approved for 1.0 contact hour(s) (which includes 0.0 hour(s) of pharmacology).

American Society of Radiologic Technologists

This activity has been reviewed and approved for 1.0 Category A CE credit by the ASRT.

European Board for Accreditation in Cardiology

This programme is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC) for 1.0 hour(s) of external CE credit(s). Each participant should claim only those hours of credit that have actually been spent in the educational activity.

Term of Offering

This activity was released on June 30, 2021 and is valid for one year. Requests for credit must be made no later than July 1, 2022.

Global Contact Information

For information about the accreditation of this program, please contact Global at 303-395-1782 or

Instructions to Receive Credit

In order to receive credit for this activity, the participant must complete the pre-activity questions, view the program in its entirety, and complete the post-activity questions, evaluation form, and credit request.

System Requirements

An Internet-connected web browser is required.    

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Global Education Group (Global) adheres to the policies and guidelines, including the Standards for Integrity and Independence in Accredited CE, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous. All persons in a position to control the content of an accredited continuing education program provided by Global are required to disclose all financial relationships with any ineligible company within the past 24 months to Global. All financial relationships reported are identified as relevant and mitigated by Global in accordance with the Standards for Integrity and Independence in Accredited CE in advance of delivery of the activity to learners. The content of this activity was vetted by Global to assure objectivity and that the activity is free of commercial bias.  

In compliance with EBAC guidelines, all speakers/chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CE activities.

All relevant financial relationships have been mitigated.

The faculty have the following relevant financial relationships with ineligible companies:

Name of Faculty or Presenter

Reported Financial Relationship
Prakash Krishnan, MD, FACC, FSCAI

Consulting Fees: Philips, BD, Abbott, Medtronic

Consulting Fees: Medtronic, BSC, Abbott Vascular, BD, LimFlow SA, Philips, OrbusNiech, PEDRA, Bypass Solutions, 3M/Acelity
Stock Shareholder: LimFlow SA


The planners and managers have the following relevant financial relationships with ineligible companies:

Name of Planner or Manager
Reported Financial Relationship
Kristin Delisi, NP
Nothing to disclose
Lindsay Borvansky
Nothing to disclose
Andrea Funk
Nothing to disclose
Liddy Knight
Nothing to disclose
Ashley Cann
Nothing to disclose
Maria DelCegno
Nothing to disclose
James Miller
Nothing to disclose
Daniel Romanowitz
Nothing to disclose
Paul J. Gagne, MD, FACS, RVT
Consulting Fees: Philips, Cook Medical, Boston Scientific
Contracted Research: Vesper, Humacyte, Boston Scientific, PQ Bypass, Merit Medical, Medtronic, Intervene
Speaker’s Bureau: Philips, Cook Medical, Medtronic, Boston Scientific

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group (Global) and Educational Awareness Solutions do not recommend the use of any agent outside of the labeled indications.  

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.


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