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What Is Critical Limb Ischemia & How to Avoid It

painful legs

What Is Critical Limb Ischemia?

Critical limb ischemia is a vascular condition that occurs when adequate blood supply fails to reach one or more limbs. When left untreated, it can result in limb amputation. Most commonly, the legs are affected. Lower limb ischemia is almost always caused by peripheral artery disease (PAD)

PAD affects more than 8 million people aged 40 and older in the United States. Along with causing a range of painful symptoms, PAD can place you at increased risk for heart attack, stroke, and limb amputation.

About one in four people with PAD experience the symptom of claudication. Claudication is muscle pain or weakness that begins with physical activity, such as walking, and stops within minutes after resting. 

Other common PAD symptoms include:

  • Leg cramping, numbness, or fatigue
  • Leg discoloration 
  • Loss of hair on legs
  • Erectile dysfunction
  • Difficulty walking or climbing stairs
  • Foot and leg pain that disturbs sleep
  • Shiny skin on the legs
  • Non-healing wounds on feet or legs
  • One leg that is cooler than the other 
  • Cold or numb toes
  • Poor toenail growth

These symptoms affect 50% of patients with PAD, while 40% may experience no leg symptoms at all.

PAD is a progressive disease, meaning that it gets worse over time. Eventually, PAD can lead to critical limb ischemia and limb amputation. Fortunately, minimally invasive, office-based treatment can reduce your health risks and improve your quality of life. Early intervention is the key to avoiding these outcomes, so it’s important to take action before symptoms progress too far.

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Is It the Same As Chronic Limb Ischemia?

Chronic limb ischemia is another term for critical limb ischemia. No matter which term is used, this serious health condition is a sign of progressing vascular disease.

Critical Limb Ischemia Symptoms

If you have peripheral artery disease, it is crucial to be on the lookout for signs of critical limb ischemia. To begin, we recommend reporting any increase in leg symptom severity to your doctor as soon as possible. This is because when it comes to limb ischemia, worsening PAD symptoms can indicate early signs of trouble.

In particular, we want you to be aware that leg pain at rest can indicate the development of critical limb ischemia. Your leg pain may be accompanied by open, non-healing sores (arterial ulcers), thickened toenails, shiny skin on legs, diminished leg pulse, and dry gangrene (dry, black skin) in the affected area. 

Critical limb ischemia will not go away on its own. If you experience any of the above symptoms, we recommend contacting your vascular specialist as soon as possible. Keep in mind that prompt medical attention can reduce your risk of limb amputation. 

If symptoms worsen within two weeks of the initial onset, please contact your doctor immediately or head to the nearest emergency room. This may indicate a medical emergency called acute limb ischemia and require urgent treatment. 

What Causes Critical Limb Ischemia?

Critical limb ischemia is usually caused by peripheral artery disease. PAD is caused by atherosclerosis, a narrowing or blockage of the arteries leading to the lower extremities. 

Atherosclerosis occurs when plaque begins to build up within the arterial walls. The plaque consists of fat, cholesterol, cellular waste products, and fibrin. Over time, plaque buildup can lead to a severe arterial blockage and critical limb ischemia

Critical limb ischemia can disproportionately affect individuals with type 2 diabetes or a family history of vascular disease. Additional risk factors include obesity, inactivity, poor diet, and smoking. 

PAD and Critical Limb Ischemia

Peripheral artery disease and critical limb ischemia are two separate, but related, conditions. To be clear, you can experience PAD without critical limb ischemia; however, critical limb ischemia almost always indicates the presence of peripheral artery disease. 

Acute vs. Chronic Limb Ischemia

In most cases, chronic limb ischemia develops over months or years. On the other hand, acute limb ischemia develops rapidly, typically within two weeks of symptoms. This is considered a vascular emergency that requires immediate treatment to avoid limb amputation.

How to Prevent and Avoid Chronic and Critical Limb Ischemia

If you have PAD, you should do everything you can to avoid limb ischemia. The good news is that following a healthy lifestyle can help reduce your risk. 

We generally recommend:

  • Maintaining a healthy Body Mass Index (BMI)
  • Exercising regularly
  • Eating a well-rounded diet
  • Quitting smoking
  • Controlling underlying health conditions like diabetes and high cholesterol 
  • Consulting a vascular specialist for close monitoring
  • Scheduling limb ischemia treatment when recommended

Treatment for Critical Limb Ischemia

To avoid limb amputation and additional health risks, we suggest exploring your available treatment options. At USA Vascular Centers, we work one-on-one with each of our patients to develop a personalized treatment plan. 

Depending on disease location and severity, your doctor may recommend a revascularization procedure to restore blood flow to the affected region. We perform a range of minimally invasive, outpatient vascular treatments

These include: 

  • Angioplasty
  • Stent placement
  • Atherectomy

Schedule a Consultation With USA Vascular Today

If you are suffering from ischemic legs, we are available to help. Our highly skilled and experienced doctors perform non-surgical vascular treatment at over 40 USA Vascular Centers nationwide. You may be surprised to learn that most of our procedures take only two hours from start to finish.

To improve your vascular health, make an appointment online today. You can easily select your preference for an in-person or virtual visit. Wherever you choose to visit us, we look forward to meeting you.




Timely detection and treatment of PAD can improve the quality of your life; help you keep your independence and mobility; and reduce your risk of heart attack, stroke, leg amputation, and even death.

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