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tool for observational studies. Outcomes of interest were amputation-free survival (AFS), major amputation and mortality after at least 12 months of follow-up. A random effects model was used for meta-analyses, if feasible. Results: A total of 27 publications were included, consisting of twenty prospective and seven retrospective studies comprising 1876 patients. Most studies included patients with no-option CLTI. Overall study quality was moderate. The pooled mortality rate after 12 months of follow-up of 15 studies consisting of 1295 patients was 18% (95% CI 12-26%, I 2 ¼ 89%). The major amputation rate from 15 studies comprising 1047 patients was 26% (95% CI 19-35%, I 2 ¼ 81%) and the AFS rate of 10 studies with 860 patients included was 51% (35-67% I 2 ¼ 94%). During the past 30 years, major amputation and AFS rates appear to have improved in conservatively treated CLTI patients. Conclusion: Conservative treatment can be a feasible treatment option in CLTI patients without revascularization opportunities, or when patients are fragile and present with significant comorbidities.
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