CLI requires prompt treatment. The type of treatment will depend on the level of symptoms, your age and overall health. Restoring proper blood flow to your hands and feet can help reduce the chances that you’ll need an amputation.
Your healthcare provider may recommend medications to prevent clots, reduce blood pressure and lower cholesterol.
Angioplasty is a procedure to open arteries that are blocked or narrowed by plaque. It can be used in arteries throughout the body to restore blood flow.
Angioplasty is performed with either sedation to allow you to relax or while you’re asleep under general anesthesia. During the procedure, the doctor inserts a catheter into a blood vessel through a small incision in the arm or groin. The doctor then guides the catheter to the site of the blockage. A balloon at the tip of the catheter then inflates, compressing the plaque against the artery wall.
In many cases, doctors use a small metal mesh tube called a stent, which is placed through the catheter. Once inside the artery, the stent helps keep it open to improve blood flow. The stent may be coated in a medicine that helps prevent the artery from narrowing again.
After angioplasty, you’ll remain at the hospital for at least a few hours, possibly overnight. Your doctor may prescribe blood thinners to prevent additional clots. You can usually resume normal activities within a week. Your doctor will guide you on how often you will need follow-up visits to check that the angioplasty is working well and the stent, if you have one, is still in place.
Carotid endarterectomy is a surgery that allows doctors to remove plaque buildup from the carotid artery. This surgery can help reduce your risk for a stroke and restore normal blood flow to the brain.
Carotid endarterectomy is performed while you are under general or local anesthesia. Your surgeon makes an incision over the carotid artery and locates the plaque-filled area. A clamp temporarily stops the blood, which allows your doctor to carefully remove the plaque buildup from the inner lining of the artery. The artery is then sewn back together, and the clamp is removed.
After carotid endarterectomy, you may spend one night in the hospital and then you can typically resume normal activity within a few weeks. You’ll visit your surgeon to have your stitches removed, and they’ll check to make sure there are no complications.
These minimally invasive procedures are performed inside the blood vessels. Such treatments may be needed when conservative therapy – such as medication and supervised exercise – has failed to help, and CLI is causing lifestyle limitations, such as being unable to work. An endovascular procedure is performed inside your artery using a thin, long tube called a catheter. Working through a small incision in the groin, your surgeon guides the catheter to the blocked area in the blood vessel. From there, the surgeon will perform an endovascular treatment, such as balloon angioplasty or stenting, to open the blocked artery.
A four-limb blood pressure measurement involves measuring blood pressure in both arms and both legs simultaneously while using a doppler ultrasound. This painless test allows doctors to assess blood flow and pressure differences between the arms and legs. By dividing the blood pressure reading of your ankle by the blood pressure reading from your arm, doctors can find your ankle-brachial index (ABI). An ABI of .9 or higher is acceptable, but an ABI of lower than .9 may mean that you have peripheral artery disease.
Treatment of wounds or ulcers may require additional surgical procedures or other follow-up care. If artery blockages can’t be addressed by a less invasive procedure, surgical treatment is often recommended. This treatment option typically involves bypassing the diseased segment with either a vein taken from your body or a synthetic graft. After this surgery, you may be in the hospital from a few days to more than a week. Recovery from surgery may take several weeks.
