My 2 pesos... My take on the Karambit is that because of it's design it's a quick draw, easily concealed bladed weapon that can open an offender up in a heartbeat, and bleed them out, especially when the timing is right, i.e. if the blade is deployed unexpectedly. The stomach, and the main arteries (inner thighs, underarms, neck, and groin) are easily sliced/ripped/torn open. If properly executed, your adversary will be dead in less than five minutes. On the contrary, in the US we generally wear thicker clothing and the inner thigh, groin, or armpits seem less accessible with the Kerambit. In this case the Balisong (Butterfly knife) or a fixed/folder is my preferred blade.