At the Center for Vascular Care at HCA, our goal is to help you manage your vascular health and protect your quality of life. If you have been diagnosed with peripheral artery disease (PAD), it is important to understand its most advanced stage: critical limb ischemia (CLI), also known as chronic limb-threatening ischemia (CLTI).
What Is Critical Limb Ischemia?
Critical limb ischemia occurs when the blood flow to your feet and lower legs drops to a dangerously low level. This is usually caused by a buildup of plaque in your arteries (atherosclerosis) that has narrowed the “pipes” carrying blood to your limbs.
While earlier stages of PAD might only cause cramping when you walk, CLI is more serious because your tissues aren’t getting enough blood even while you are resting. This can lead to constant pain, wounds that won’t heal, and a risk of tissue damage. Because CLI affects about 2 million people in the U.S., our team is dedicated to providing the early intervention needed to manage this condition.
Who Is at Risk of Critical Limb Ischemia?
If you are already living with PAD, you may be at a higher risk for CLI—especially if you have diabetes, a history of smoking, or kidney disease. It’s also important to know that CLI is often a signal about your heart health overall, as the same blockages in your legs may also be present in other parts of your body.
While the long-term outlook for untreated CLI can be serious, getting a prompt diagnosis and starting a treatment plan with us can significantly change your path forward.
Recognizing the Symptoms
One of the most common signs of CLI is pain that wakes you up at night. You might feel a deep, burning ache in your toes or the arch of your foot that starts when you lie down. You may find temporary relief by dangling your leg over the side of the bed, which uses gravity to pull a little more blood into your foot.
Other signs to watch for include:
- Sores or wounds on your feet or legs that just won’t heal.
- Skin that looks purple, dark red, or black in certain areas.
- Foot coolness or numbness, or skin that appears thin and shiny.
How We Diagnose CLI
Your journey to better health starts with a simple physical exam. We will check the pulses in your legs and feet, look at any wounds you may have, and talk through the pain you’re feeling.
To get a clearer picture, we may use non-invasive tests like:
- Ankle-Brachial Index (ABI): Comparing the blood pressure in your ankle to your arm.
- Toe-Brachial Index: A similar test that is often more accurate if you have diabetes.
- Imaging: If we decide a procedure is necessary, we use advanced imaging to map out exactly where the blockages are so we can plan the best approach for you.
Treatment Options: Saving Your Limb and Protecting Your Heart
At the Center for Vascular Care at HCA, we tackle CLI on two fronts: managing your overall health and restoring blood flow to your leg.
- Managing Your Health
We may prescribe medications to control blood pressure and cholesterol, or help you with a smoking cessation program. These steps protect you against heart attack and stroke while we address the blockages in your legs.
- Restoring Blood Flow
To save the limb and stop the pain, we often need to “reroute” the blood. Our objective is always to use the least invasive method possible. Options include:
- Endovascular balloon angioplasty: Using a tiny balloon to open the artery from the inside.
Bypass Surgery: Creating a new path for blood to flow around the blockage using a healthy vein or a synthetic graft.
Speak With a Vascular Specialist
The most important thing to remember about CLI is that the window for treatment matters. Early, decisive care gives you the best chance of preserving your limb and returning to your daily routine.
If you are experiencing pain, non-healing wounds, or changes in your skin color, don’t wait. Our specialists provide the highest-quality vascular care across New Jersey.
Contact the Center for Vascular Care at HCA today to schedule an appointment and get the personalized diagnosis you deserve.