Critical limb ischemia (CLI), also known as chronic limb-threatening ischemia, occurs when the blood flow to the arms, legs or feet is severely reduced or blocked. This condition causes intense pain, numbness and slow-healing sores in the extremities. CLI is a serious chronic condition that increases the risk of heart complications and, in the most severe cases, can lead to limb amputation.
CLI is the most advanced stage of peripheral artery disease (PAD). PAD occurs when arterial blockages caused by fatty substances called plaque (atherosclerotic plaque) build up and reduce blood flow. With limited blood flow, it’s harder for muscles and tissue to stay healthy and strong, and sores are slow to heal.
More than 10 percent of adults in the United States have CLI. It affects slightly more men than women. The highest rates of CLI occur in older people, smokers and those with diabetes. The sooner you get treatment, the higher your chances of a good outcome.
If you have carotid artery disease – or experience other health concerns or an emergency – our experts at the Comprehensive Vascular Clinic at the UK Gill Heart & Vascular Institute are here to help. We offer advanced diagnostic tools and comprehensive treatment options for patients in Kentucky.
The most common symptom of CLI is intense leg and foot pain while sitting still. This pain often comes on at night and can wake you up.
Other symptoms and warning signs include:
- Absent or reduced pulse in the legs or feet
- Cold lower leg or foot compared with the rest of your body
- Dry gangrene (dry, black skin) of the legs or feet
- Open sores, skin infections or ulcers that won’t heal
- Shiny, smooth, dry skin of the legs or feet
- Thickening of the toenails
The cause of CLI is obstructive PAD in its most severe form. CLI patients have the same risk factors that cause PAD. However, generally, they have more severe forms of the risk factors or more than one risk factor.
While everyone experiences some level of plaque buildup in the arteries as we age, you can take steps to limit that buildup. You can lower your risk of CLI by getting treatment for PAD. You can also reduce your risk factors by taking these steps:
- Eat a healthy diet. Get plenty of fruits and veggies, lean meats, nuts, beans, fish and whole grains. Limit sodium, added sugars and unhealthy fats.
- If you smoke, quit. Smoking can increase your risk for heart attack and stroke. Avoid vaping and secondhand smoke as well.
- Manage other health problems. Take medication for high blood pressure and diabetes and follow your provider’s guidance.
- Reduce stress. Focus on healthy coping techniques, such as meditation or talk therapy.
- Stay physically active. Try to get at least 30 minutes of moderate exercise five days a week. Talk to your provider about what exercises are good for you. Be sure to watch for signs that your heart is working too hard. If you become short of breath or dizzy while exercising, stop and rest.
- Watch your weight. Take steps to reach and maintain a healthy weight.
Some risk factors for CLI can’t be changed, such as age or family history, but many risk factors are related to lifestyle habits.
Risk factors include:
- Age (men over 60 and women after menopause)
- Chronic kidney disease
- Diabetes
- Family history of atherosclerosis or claudication (muscle pain during sustained exercise)
- High blood pressure (hypertension)
- High cholesterol (hyperlipidemia)
- Overweight or obesity
- Sedentary lifestyle
- Smoking and using tobacco products
CLI can lead to serious complications, including amputation and a shortened lifespan. More than 10 percent of adults in the United States have critical limb ischemia. Almost 1 in 3 of those people have an amputation and about 1 in 4 die from related issues.
If you have symptoms, see your doctor right away. If you are diagnosed with CLI, you will need immediate treatment to restore proper blood flow and limit damage to the extremities. The earlier you get treatment, the less likely you are to have severe problems. Effective treatment for CLI can also help limit the risk of further plaque buildup and blockages.
In most cases, your first visit to UK HealthCare Comprehensive Vascular Clinic is a time of education and introductions. You meet members of your care team and learn about detecting, treating and managing your vascular condition.
Diagnosing vascular disease is a unique process that requires detective work. One of the most important steps toward diagnosis is listening to your story. Your team will ask a lot of questions about your symptoms and medical history. The goal is to gather all the information that can help pinpoint the source of your vascular issue.
Along with discussing your medical history, you will undergo a physical examination. Your care team will then be able to determine the proper next step to take on your diagnostic journey.
When appropriate, your team may prescribe one or more diagnostic tests. These tests typically take place on a different day, and your care team helps schedule them at your convenience. In some cases, you will undergo an ultrasound or other testing as part of your initial visit.
When coming to your first vascular appointment, plan to do the following:
- Arrive early. You may need to fill out paperwork when you arrive. Getting to your appointment early ensures you have time to complete paperwork without feeling rushed.
- Bring a current list of medications or supplements you take. You should also list any previous surgeries, symptoms you’ve experienced and other past health issues.
- Dress comfortably. Working toward a diagnosis takes time. Comfortable clothes help you remain relaxed and attentive throughout your visit. They also make it easier for your team to perform your physical exam.
- Eat and drink normally. In most cases, you won’t undergo imaging or other testing at your first visit. Therefore, there are no dietary restrictions. If specialized testing is part of your first visit, a team member will call to explain any dietary restrictions to follow for your visit. We will also mail you a letter with instructions.
- Have your insurance information on hand. UK HealthCare accepts most insurers, and financial assistance is available.
- Request a loved one to join you. Bring a family member or friend with you to take notes and ask questions you may not think of asking.
Where we are
UK HealthCare Comprehensive Vascular Clinic is located at 740 S. Limestone on the fifth floor, wing D, room L-504.
Where to park
Please park in the parking garage across the street, which is located at 140 Huguelet Drive. For easiest access, drive to the back of the garage and use one of the parking spots reserved for patients of the Comprehensive Vascular Clinic. Once inside, you can access further assistance at the information desk. Wheelchairs are available upon request.
Our vascular care experts help residents of Central Kentucky and beyond improve their vascular health every day. To improve the future of treatment and management of vascular conditions, they also participate in clinical trials.
At any given time, our staff engages in trials for new treatments and devices that provide better treatment and management of vascular conditions. By offering access to clinical trials, we provide access to vascular treatment not available at many other facilities.
If you’re a candidate for an ongoing trial, your care team will discuss the possibility with you.
SCHEDULE AN
APPOINTMENT
CONNECT WITH US ON
SOCIAL MEDIA
