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