In this article, Dr. Kevin Herman explains the symptoms, risk factors, and treatment of critical limb ischemia.
What is Critical Limb Ischemia?
Critical Limb Ischemia or CLI is an end-stage form of peripheral arterial disease (PAD). Peripheral arterial disease or peripheral vascular disease is when there can become blockages of some of the blood vessels in the lower extremities or sometimes in the upper extremities. It’s a similar manifestation of the same type of disease that happens in the coronary blood vessels, the blood vessels that go to the heart or the blood vessels that go to the brain. So as we mentioned, critical limb ischemia is the most severe form of this type of disease process.
What are the Symptoms of Critical Limb Ischemia?
Symptoms of peripheral arterial disease and its most end-stage form of CLI may include pain upon walking and at rest. Sometimes while just sleeping, you need to hang your legs over the side of the bed to get blood flow to them.
The problem with the disease is there’s a lack of blood flow. Patients can develop non-healing wounds on their lower extremities, and blood flow needs to get to those wounds. One of the other manifestations is non-healing wounds, which can then progress into gangrene.
What are the Risk Factors of Critical Limb Ischemia?
CLI is really a manifestation of PAD. They have similar risk factors, including:
- Poor Diet
- High Blood Pressure
Diabetes is also a very specific and strong risk factor for the development of PAD, and more specifically, CLI.
Can Changing Lifestyle Factors Help Reverse CLI?
When someone develops CLI, it’s really more of an end-stage type of disease. However, patients who develop rest pain or wounds are treated successfully by improving the blood flow towards the lower extremities. They can improve their lifestyle and the overall disease process by stopping smoking, changing their diet, or keeping a tight control on their glucose (if one suffers from diabetes).
Specifically, the hemoglobin A1C levels, which is really a manifestation overall of one’s metabolic component over the past several months, is a key indicator in patients to continue to keep those vessels open. It’s what we call “to maintain patency” or to help in healing those wounds. In fact, once somebody does have this diagnosis, although it is the end stage, we can alter the disease process with lifestyle changes as well as medication and having the patient stop smoking.
How Does American Endovascular Help Treat CLI?
The physicians at American Endovascular have a real passion for treating CLI and for helping those patients with this end-stage disease. Specifically, we initially start off with our consultation, which is to provide a real workup and medication review. Once we make a diagnosis, we’ll make any modifications to medications and lifestyle based on patient risk factors.
Since CLI is an end-stage disease, most patients will require a minimally invasive type of procedure that may include angiography, which looks at the blood vessels of the lower extremities. We have specific tools and techniques that we’re developing here at American Endovascular & Amputation Prevention to increase the blood flow going down to those patients’ lower extremities and for the maintenance of patency.
One of the nice things that we’re able to accomplish here is that it’s all done on an outpatient basis. So the patients are here at one of our vascular centers for only a few hours of the day for their procedure and are able to return home in a timely fashion.
Request a Consultation with Dr. Herman
If you think you may have symptoms of critical limb ischemia, request a consultation with Dr. Kevin Herman at NJ Endovascular & Amputation Prevention today.