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Common Causes of Critical Limb Ischemia

critical limb ischemia

Critical limb ischemia (CLI) is a serious condition that occurs when there is a severe blockage in the arteries of the legs and feet. If left untreated, this disease can lead to gangrene, amputation, and even death. Studies show that about 40% of patients diagnosed with CLI require major lower extremity amputation.

CLI significantly reduces blood flow and occurs in the later stages of peripheral artery disease (PAD). This condition can develop if PAD is not diagnosed and treated early enough. PAD is caused by plaque buildup in the arteries, which is also known as atherosclerosis, and most commonly affects the legs. Blood flow becomes restricted, and adequate oxygen can not be carried to the leg muscles. 

For personalized treatment recommendations to help prevent the progression into critical limb ischemia, request a consultation with one of our expert vascular doctors today.



Signs and Symptoms of Critical Limb Ischemia

CLI is accompanied by symptoms that can be debilitating and impact the quality of your life, including severe pain in the feet, which reaches down to the toes. When this pain continues even when you are resting, it is known as ischemic rest pain. It differs from the claudication seen in the early stages of PAD. Claudication is pain that is triggered by physical activity but stops at rest. However, as PAD progresses into critical limb ischemia, claudication becomes more frequent and can even occur while at rest. 

Ulcers on the feet or legs that won’t heal are another common symptom of CLI. These wounds can become infected, leading to gangrene (dry, black skin) and an increased risk of amputation. Other symptoms include:

  • Numbness in the feet
  • One leg colder than the other
  • Shiny skin or dry skin on the legs and feet
  • Thickened toenails
  • Faint pulse in the legs or feet

If you notice these symptoms, even without ischemic rest pain, it might be an indication of a severe form of PAD, and seeking a diagnosis from a vascular specialist can help you determine the best course of action for your health.

Risk Factors and Causes of Critical Limb Ischemia

Since critical limb ischemia is a severe form of PAD, the primary risk factor for developing CLI is untreated atherosclerosis. As atherosclerosis is the primary cause of PAD, the risk factors for PAD and CLI are similar, including:

  • Age
  • Smoking
  • Obesity
  • Diabetes
  • Inactive lifestyle
  • High cholesterol
  • High blood pressure
  • Family history

Critical Limb Ischemia Diagnosis, Treatment Options, and Prognosis

To diagnose CLI, your vascular doctor will perform a physical examination and may use one of the following tests to confirm the condition:

  • Ankle-brachial index, which compares the blood pressure of the ankle with that in the arm.
  • Ultrasound, which measures the direction and velocity of blood flow.
  • CT angiography, which is an advanced X-ray that uses contrast dye and captures images of the blood vessels to determine blockage.

Once a diagnosis is made, treatment is the next critical step. Since CLI occurs when PAD has progressed into a later stage, a procedure can be performed to unblock the narrowed arteries and restore blood flow to relieve symptoms and prevent the condition from worsening. Your vascular specialist may recommend one of several treatment options:

  • Angioplasty: During this procedure, an interventional radiologist inserts a tiny catheter in the affected artery and inflates the balloon on the tip to compress the plaque buildup against the walls, allowing blood to flow through at a normal rate.
  • Stent placement: A wire mesh tube is inserted into the affected artery to hold it open after the catheter is removed.
  • Atherectomy: In this procedure, a small catheter with a blade is used to scrape away the plaque from the artery walls.

The prognosis for CLI depends on how early treatment is sought. With ongoing care to prevent the progression of the disease after the procedure, the prognosis is typically positive.  

Schedule a Consultation with USA Vascular Team

Critical limb ischemia is a serious condition; however, treatment is available to prevent further damage. At USA Vascular Centers, our team of expert vascular doctors performs non-surgical, outpatient procedures that can alleviate your pain and help you regain your mobility. Schedule a consultation at one of our accessible centers across the country or give us a call at 888.773.2193.


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