Critical Limb Ischemia

Critical limb ischemia is a type of peripheral artery disease (PAD). This condition occurs when a blockage within an artery significantly reduces blood flow to the arms or legs.

It’s important to promptly seek care for critical limb ischemia, since failing to treat this condition can lead to the need for amputation. In fact, if blood flow to the affected limb is completely blocked, tissue can begin dying within just a few hours.

Causes of Critical Limb Ischemia

Critical limb ischemia generally results from plaque buildup within an artery, which causes the artery to narrow and harden (atherosclerosis). The following risk factors can increase the likelihood of developing critical limb ischemia:

• Advanced age (it most often affects postmenopausal women and men over the age of 60)
• Being overweight
• Leading a sedentary lifestyle
• Smoking
• Having diabetes, high blood pressure or high cholesterol
• Having a family history of cardiovascular disease

Symptoms of Critical Limb Ischemia

Critical limb ischemia can cause the following symptoms in the affected limb:

• Pain while resting (known as ischemic rest pain)
• A burning sensation
• Numbness
• Shiny, smooth and dry skin
• Skin that feels cool compared to the rest of the body
• Gangrene
• Sores, infections, ulcers and wounds that either heal slowly or won’t heal at all
• Thickened nails
• Weakened pulse

Ischemic rest pain can be so severe that it causes someone to wake up in the middle of the night. Patients can often relieve this pain by sitting up and dangling their feet over the side of the bed, or getting up and walking around.

Diagnosing Critical Limb Ischemia

Physicians can use a number of different methods to diagnose critical limb ischemia, including:

• Angiogram
• Ankle-brachial index test
• Auscultation
• Computed tomography (CT) scan
• Doppler ultrasound
• Magnetic resonance imaging (MRI) scan

Treatment for Critical Limb Ischemia

Treatment of critical limb ischemia is geared towards restoring blood flow to the affected limb. The vascular specialists at Tampa General Hospital often treat critical limb ischemia using:

• Medication to relieve pain, lower blood pressure or cholesterol and prevent blood clotting
• Endovascular therapy
• Surgery