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What is Critical Limb Ischemia?
Critical limb ischemia (CLI) is an extreme blockage in the arteries of the lower extremities, which greatly reduces blood-flow. CLI is a chronic condition that causes extreme pain in the feet or toes, even while at rest. Additional complications of poor circulation can include sores and wounds that won't heal in the legs and feet.
If left untreated, symptoms will continue to digress and could result in the amputation of the affected limb. CLI requires medical attention from a professional as the condition will not improve on its own.
In its early stages, Critical Limb Ischemia does not show any symptoms. That is why the first sign of the disease is typically a stroke or transient ischemic attack (TIA), caused by a lack of blood to the brain. Signs of stroke or TIA include sudden numbness in the face or on one side of the body, confusion, trouble speaking, dizziness, blurred vision, or severe headache.
An accurate diagnosis of Critical Limb Ischemia is dependent upon the location of the disease. A cardiologist will use one of the following methods to detect and monitor your arterial health.:
Endovascular treatments are innovative, less invasive procedures used to treat problems affecting blood vessels.
Minimally invasive endovascular procedures are now the first option for treating Critical Limb Ischemia. The treatment option is dependent upon the location and proportion of the blockages.
Some of the common endovascular procedures used to treat Critical Limb Ischemia are:
Endovascular procedures for treating CLI provide a much shorter recovery time compared to other surgical options. Recovery time from endovascular procedures treating CLI is only one to two days. Most endovascualar procedures are conducted on an outpatient level.
Some CLI conditions are not favorable for an endovascular procedure. When arterial blockages are not suitable, surgical treatment is recommended. Surgical procedures for the treatment of CLI often involves bypass around the diseased segment with either a vein from the patient or a synthetic graft. Patient recovery after a CLI surgical procedure can take several weeks.
Why is Limb Salvage linked with Critical Limb Ischemia (CLI)?
Current medical consensus suggests amputation is the best way to treat patients with CLI. Dr. Craig Walker of the Cardiovascular Institute of the South, however, has proven that CLI can be treated without amputation.
Patients who undergo amputations to limit damage from CLI suffer many negative consequences.
To increase quality of life, physicians should make every attempt to avoid amputation.
Dr. Walker identifies techniques that help delay or prevent amputations.
In some cases, hyperbaric treatment and minor amputations may be needed.
CLI and amputation are not inextricably linked. Factors like lifestyle habits, comorbidities, and the progress of the disease should dictate individual treatment plans. A team of medical professionals should evaluate patient cases before granting an amputation.
CLI-related conditions are a spectrum. While connected by a common source, conditions on each end of the spectrum are vastly different. Dr. Walker uses the concept of the continuum of care to illustrate the need for early identification and referrals for revascularization.
With today’s technology and medical knowledge, limb salvage has become a safer and more cost-effective alternative to amputations.