Major adverse lower limb events (MALEs) continue to pose a serious challenge in the peripheral artery disease population. Despite the application of multiple surgical and endovascular revascularization strategies, patients with chronic limb-threatening ischemia (CLTI) may experience complications such as amputation and reintervention at rates exceeding 60 %, spurring the development of several validated risk scores designed to stratify patients and idealistically guide management [ 1 ].