When would amputation be the choice of treatment?

when would you choose to amputate a limb? Well the first answer to that is we, what we do is do our best in almost all circumstances to avoid amputation. Limb amputation is in most cases the outcome that diabetes for multidisciplinary teams spend their lives trying to avoid. We've done some work recently in the Northeast looking at all major amputations which is of amputations above the level of the ankle carried out in the Northeast of England and looked at the the underlying causes of of major amputations across all trusts in Northeast. The most common cause of a major amputation is a blockage to the blood supply which cannot be treated, cannot be improved. So there are some people who have blockages to the arteries in such a way that there's no treatment for them. In most cases artery disease, artery blockages can be treated either by angioplasty, putting a a balloon, a wire with a balloon down it into someone's artery from the groin while they're awake and opening the artery up. Or other people that can be improved by a bypass graft by plumbing a vein in above and below the blocked artery to take blood through a new pathway. But there are unfortunately some people in whom neither of those procedures is possible and that is the most common cause of amputation. Occasionally amputation can be done because of very severe infection, but that's less common.