Understanding Critical Limb Ischemia (CLI) 

Critical limb ischemia (CLI) refers to a condition in which a person has extensive blockages in the arteries of the lower extremities, typically the legs. CLI is an advanced form of peripheral arterial disease (PAD), in which arteries that have become narrow reduce the flow of blood to the limbs. CLI can cause tissue damage and loss of limbs (amputation). 

The symptoms of peripheral arterial disease (PAD) include: 

  • Cramping of the leg, thigh or hip muscles
  • Experiencing cramps after walking or climbing stairs
  • Numbness or weakness in the legs
  • Legs or feet feel cold on one side, or have sores that won’t heal 

The signs of critical limb ischemia (CLI) include: 

  • Severe pain, numbness or a burning sensation in the legs or feet
  • Infections, sores or ulcers in the feet or toes that won’t heal
  • Gangrene
  • Limbs feel cold or a loss of sensation in the limb
  • Limb pain is a “resting pain,” in that it persists when one is resting or asleep 

Risk factors for CLI 

Critical limb ischemia requires immediate medical attention. If not treated, the health complications of CLI can result in the amputation of the limb that has the blockage. 

The risk factors for CLI are the same as the risk factors for atherosclerosis, a hardening and narrowing of the arteries caused by a buildup of plaque (fatty deposits). Risk factors of CLI include: 

  • Smoking
  • Age (men over age 60 and women who are postmenopausal)
  • A family history of cardiovascular disease
  • High cholesterol
  • High blood pressure
  • Lack of exercise
  • Obesity 

Endovascular Intervention for Critical Limb Ischemia (CLI) 

In treating CLI, the main priority is saving the limb. Treatment also involves improving blood flow and reducing pain. Cardiologists at Denver Heart specialize in a number of endovascular intervention procedures, which open the blood vessels in order to avoid amputation and improve symptoms of CLI. An endovascular intervention is a minimally-invasive procedure that does not require major surgery. 

During an endovascular intervention procedure, a catheter is inserted into the artery in the groin, which allows the surgeon to access the infected part of the artery. Then, a surgeon inserts a small balloon and inflates it in the artery, which opens the artery and improves blood flow. A stent is used to keep the artery open and increase blood flow to the limb. 

There are other types of procedures performed to treat CLI, such as an atherectomy (removing plaque from a blood vessel). 

Surgical Treatment Options for CLI 

In some cases, if the arterial blockages in the limb are severe or not favorable for an endovascular intervention procedure, a patient might need surgery. These surgical procedures include a leg artery bypass or coronary artery bypass grafting (CABG) surgery, or a carotid endarterectomy. 

Treating CLI might also involve medications, which can prevent further progression of the disease, decrease pain and reduce one’s risk factors, like high blood pressure or high cholesterol. There are also medications for CLI that prevent blood clotting or work to combat various infections. 

Expert Cardiac Specialists in Denver 

At Denver Heart, our board-certified cardiologists are committed to offering the latest and most innovative treatment options to our patients. This includes cutting-edge, minimally-invasive surgical procedures to treat cardiovascular disease and medical conditions related to the arteries and blood vessels. Our specialists are always on hand to answer any questions you have about keeping your heart healthy and reducing your risk factors for cardiovascular disease.