Critical Limb Ischemia Surgeon Los Angeles

Critical Limb Ischemia (CLI) also known as limb salvage

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What is Critical Limb Ischemia (CLI)?

Critical limb ischemia (CLI) is the result of advanced untreated peripheral artery disease (PAD) or peripheral vascular disease (PVD). When blockages in your legs completely obstruct blood flow, the tissue in your leg or foot can die causing gangrene or tissue death. If this lack of blood flow remains untreated your foot will turn black as the tissue death continues, and you could need an amputation of the affected body part.

Critical limb ischemia from vascular disease will not resolve on its own without surgical treatment. You may develop ulcers on your feet that do not heal as a result of CLI. In order to heal these ulcers, you need treatment that will restore the blood flow to your feet by opening the blockages in your legs.

Critical Limb Ischemia Q & A

Image shows an artery that is completely blocked and narrowed by yellow fatty plaque that has built up inside the artery wall, a condition called critical limb ischemia

Chronic Total Occlusion/ Critical Limb Ischemia. Image shows an artery that is completely blocked and narrowed by yellow fatty plaque that has built up inside the artery wall.

What are the risk factors for Critical Limb Ischemia?

Current or previous smoker
High blood pressure
Age > 50 years old
Diabetes
High cholesterol
Coronary artery disease
Atherosclerosis
Black or Hispanic
Male
Family history
Obesity
Untreated or unresolved PAD

Signs and Symptoms of Critical Limb Ischemia

Foot/ leg pain at rest
Ulcers on the foot that do not heal
Gangrene or dry black skin on the feet
Absent or reduced pulse in the legs or feet
Pain, numbness, tingling in the legs or feet
Painful cramping in the hip, thigh or calf
Feeling of coldness that occurs in one leg/foot more than the other
Loss of hair or slow growing hair on the legs and feet
Slow growing toenails
Shiny skin on the legs or feet

Is amputation the only option for CLI?

Sadly, about 30% of patients with critical limb ischemia are treated with amputation even without the presence of an ulcer or gangrene and without any endovascular evaluation. If you have been diagnosed with critical limb ischemia and have been offered amputation as your only treatment option, seek a 2nd opinion with a vascular specialist to determine if a minimally invasive procedure like endovascular treatment should be attempted before amputation.

Treatment Options for Critical Limb Ischemia (CLI)

Endovascular repair with any combination of the following: nitinol stent, balloon expandable stent, Drug Coated Balloon (DCB), Drug Eluting Stent atherectomy, and/ or Shockwave™
Surgical repair using bypass
Surgical endarterectomy
Minimally invasive repair using a combination of bypass and stenting
As a last resort, amputation

The introduction of new balloons and stents with drug coatings have improved treatment outcomes for patients with CLI, offering long term relief and preventing the need for repeated interventions over time.

If you are interested in learning more about the newest treatment options Drs. Eghbalieh and Abi-Chaker use to treat critical limb ischemia, check out the videos below:

Our Vascular & Endovascular Surgeons

It's important to remember not all physicians are trained in advanced vascular and endovascular surgery. It’s a good practice to get multiple opinions and do research on the surgery and the physician.