“…5 Lower extremity bypass surgery, even when successful, is associated with a 30-day mortality of 2% to 8%, 5-year graft failure rates of 20% to 90%, and 5-year risk of amputation that remains as high as 20%. 6 Leg amputation is associated with an impairment of functional status, reduced quality of life, and high mortality. [7][8][9][10][11] Thus, although most prior PAD specific clinical trials have evaluated interventions to decrease systemic ischemic events, or to improve claudication, the role of process of care to reduce limb events has received much less attention.…”