CLI treatment

Critical Limb Ischemia

Endovascular treatment could help you avoid amputation. 

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Critical Limb Ischemia & Non-Healing Wounds

Critical Limb Ischemia (CLI) is a condition that occurs when there is not enough blood reaching the legs. The decreased blood flow occurs because of blockages in the arteries. CLI is the most serious form of Peripheral Arterial Disease (PAD), caused by atherosclerosis, the hardening and narrowing of the arteries due to the buildup of fatty deposits called plaque.

CLI can cause severe leg pain, mostly in the calf and foot, which is often made worse when you lie down and is improved with sitting or standing. With CLI, you may also have problems with non-healing wounds on your legs and feet. If left untreated, these complications can result in amputation. 

If you’ve been told you need an amputation or are at risk due to CLI, get a second opinion by calling for an evaluation today. For many patients, our revascularization procedures can be an effective alternative to amputation.

What Are the Risk Factors for CLI?

Those that are at high risk should be screened for this disease. Early detection and prevention can help prevent disease progression. Risk factors include:

  • Over 50 years old
  • Current or former smoker
  • Diabetes
  • Overweight or obesity
  • Sedentary lifestyle
  • High cholesterol
  • High blood pressure
  • Family history of atherosclerosis or claudication (pain in lower extremities that occurs with activity and subsides with rest)

Diabetes & Non-Healing Wounds

The problem with non-healing wounds is often a lack of blood circulation because of narrowing in leg arteries, a condition common to diabetics called peripheral artery disease (PAD). According to the American Diabetes Association, an estimated 1 out of every 3 people with diabetes over the age of 50 has PAD. Diabetes, which causes high blood sugar, results in inflammation and changes in cells that can damage the arteries and lead to blockages. Millions of Americans have diabetes and many who have the disease lose sensation in their feet because of nerve damage or restricted blood circulation.

Left untreated, CLI can lead to amputation. When a person is suffering from PAD or CLI, small wounds on the heel or foot tend to exacerbate into a serious problem, which can often lead to amputation. Amputation is one of the most serious, and perhaps least talked about, consequences of diabetes. Losing a limb can cause a domino effect of declining health. Diabetics who lose one leg have a 50 percent chance of losing the other within five years; double amputees have a 70 percent chance of dying within five years.

What Are the Symptoms of CLI?

The most common features of Critical Limb Ischemia include:

  • Sores or wounds on the feet and toes that do not heal
  • Dry gangrene (dry, black skin) of the legs or feet
  • Severe pain or numbness in the calves and feet
  • Shiny, smooth, dry skin of the legs or feet
  • Thickening of the toenails
  • Absent or diminished pulse in the legs or feet

How is CLI Treated?

Critical limb ischemia is a serious condition that requires urgent treatment to re-establish blood-flow to the affected limbs. The treatment goal is to prevent amputation, relieve pain and allow non-healing wounds to heal. Blood flow is restored using minimally invasive endovascular techniques or open surgical bypass grafts.

Minimally invasive endovascular procedures have excellent outcomes with the majority of patients experiencing pain resolution and wound healing. In the last decade there have been tremendous advances in devices and techniques to treat blocked arteries, allowing most patients to avoid open surgical procedures. The location and severity of the blockages will determine the specific treatment(s) used. Some of those procedures include:

  • Angioplasty — a catheter with a balloon is passed through the blocked artery. Once inflated, the balloon compresses the plaque against the wall of the artery.
  • Stent implantation — during angioplasty, a tiny metal mesh tube called a stent may be placed in the artery to help hold it open.
  • Atherectomy — a special catheter is used to gently shave and remove plaque from the arteries.
angioplasty at CDI Vascular Care

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