Critical limb ischemia is a severe stage of peripheral artery disease, in which you have significant blockages in the blood flow to your arms, legs or feet. This increases your risk of heart complications. Some people need an amputation to treat critical limb ischemia. The sooner you get treatment, the higher your chances of a good outcome.
Critical limb ischemia is severely blocked blood flow to your one or multiple of your hands, legs or feet. It causes intense pain, numbness and slow-healing sores on your feet, legs or hands. It is a serious condition that increases your risk of heart complications, limb amputation and death.
Critical limb ischemia is a severe stage of peripheral artery disease (PAD). PAD occurs when a fatty substance called plaque (atherosclerotic plaque) builds up inside your arteries and restricts blood flow. It’s harder for your muscles and tissue to remain healthy and strong, or to heal, with limited blood flow. Another name for critical limb ischemia is chronic limb-threatening ischemia.
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Anyone with PAD can develop critical limb ischemia. Your risk increases as you get older.
Other risk factors include:
Yes. Critical limb ischemia significantly increases your risk of major medical complications, including death. Within one year of developing critical limb ischemia:
More than 10% of adults in the United States have critical limb ischemia. The condition affects slightly more men or people assigned male at birth than women or people assigned female at birth.
The most common symptom of chronic limb-threatening ischemia is an intense foot or leg pain. Often, this pain wakes you up at night. You may hang your leg off the edge of your bed or get up and walk around to relieve the pain. Some people don’t feel any pain, but notice other symptoms like the following:
Peripheral artery disease causes chronic limb-threatening ischemia. Chronic limb-threatening ischemia develops when you have narrowed or blocked arteries for months or years.
Your healthcare provider may suspect critical limb ischemia based on your symptoms and other medical problems. They may use additional tests such as CT scans, MRIs, angiograms or ultrasounds. These tests evaluate:
Critical limb ischemia requires prompt treatment. 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:
If none of these treatments adequately restore blood flow, your healthcare provider may need to remove part of your finger, hand, toe, foot or leg. About 1 in 5 people with critical limb ischemia eventually need an amputation. People with diabetes are much more likely to need an amputation.
You can lower your risk of chronic limb-threatening ischemia by getting treatment for PAD. You may also reduce your risk factors by:
Chronic limb-threatening ischemia can lead to serious complications, including a shortened lifespan. If you have any chronic limb-threatening ischemia or PAD symptoms, see a healthcare provider right away. The earlier you get treatment, the less likely you will experience severe complications or need an amputation.
Critical limb ischemia has high mortality rates. About half of people with the condition live for more than five years after their initial diagnosis. Many people with critical limb ischemia die of cardiac complications or strokes.
If you have critical limb ischemia or think you could, you may also want to ask your healthcare provider:
Yes. Walking may relieve some of the pain associated with critical limb ischemia. Regular movement and walking also increase blood flow to your legs, which is recommended for critical limb ischemia. If you notice increased pain in your legs with walking, you should talk to your healthcare provider.
A note from Cleveland Clinic
Chronic limb-threatening ischemia occurs when you have severely blocked blood flow to your hands, legs or feet. It is an advanced stage of peripheral artery disease. Critical limb ischemia significantly increases your risk of heart problems and a shorter lifespan. Getting treatment right away improves your chances of a good outcome, including avoiding amputation.
Last reviewed by a Cleveland Clinic medical professional on 05/23/2022.
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