Critical limb ischemia (CLI) is the end stage of peripheral artery disease (PAD). PAD occurs when atherosclerosis builds up inside your arteries and slows blood flow. Tissues that are starved of blood will be slow to heal, start to fail and eventually die. Critical Limb Ischemia can cause intense pain, numbness and slow healing sores on your feet, legs or hands. This is a serious condition. It can progress to limb amputation or death. CLI is a sign that all the arteries in your body may be involved. You may have problems in your heart blood vessels , and you may have poor blood flow to your brain. Poor blood flow to the brain means poor brain function. Memory loss, decreased reasoning skills, slow understanding of new tasks, disorientation and poor navigation eventually ending in a stroke.
Risk factors to look for.
If you have these risk factors consider PAD. Feel for your pulses.
- Chronic kidney disease.
- Diabetes.
- High blood pressure (hypertension).
- High cholesterol (hyperlipidemia).
- Smoking and using tobacco product
Is critical limb ischemia life threatening?
Yes. It may be a warning that all your blood vessels all over your body may be narrowed with plaque. Critical limb ischemia significantly increases your risk of major medical problems, including death, within one year of critical limb ischemia starting.
- Almost 1 in 3 people have an amputation.
- About 1 in 4 people die, most commonly from heart disease or a stroke.
Symptoms of Critical Limb Ischemia
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:
- Cold hands, feet or legs.
- Feet that appear smooth, shiny, very dry and with no hair.
- Weak or no pulse in your legs or feet. Can you feel your pulses anywhere?
- Numbness in your legs, feet or hands.
- Slow-healing sores on your feet or legs.
- Skin discoloration or discharge from gangrene.
- Thick toe nails.
Diagnosis
CT scans, MRIs, angiograms or ultrasounds
Treatment of Critical Limb Ishemia
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.
- Medications to prevent clots, reduce blood pressure and lower cholesterol. Pain tablets and NSAIDs.
- Endovascular treatments (minimally invasive), such as angioplasty (placing a stent) to open blocked arteries or atherectomy to remove plaque buildup.
- Surgery to repair or replace an artery either using one of your own veins or a man made replacement.
- SVF is a rich combination of stem cells, cytokines and growth factors. This is a powerful treatment for all your arteries all over your body.
Amputation
If damage cannot be stopped or reversed you 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. 80% of people are able to avoid amputation with the lifestyle changes listed below. People with diabetes are much more likely to need an amputation. SVF treatment is significantly improving outcomes for CLI.
Prevention
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 heart attacks or strokes. You need to treat all your blood vessels. When SVF is injected into a vein it is attracted to sites of inflammation in arteries all over your body.
- Stop smoking. Smoking narrows the blood vessels even further and increases clotting.
- Minor changes to your diet will help obtain optimal weight for your age, sex and body type. These changes will also reduce inflammation in your arterial walls.
- Exercise regularly. Any movement will help keep you alive. Further benefits have been shown if you can do strength training, stretching and aerobic exercises.
- There is evidence that controlling blood pressure and cholesterol may help.
- Managing any co-existing conditions, such as diabetes will improve your results.
- Reduce stress.
SVF for CLI
Critical Limb Ischemia is a vascular problem. The vessels all over your body are affected, some more than others. SVF can reverse some the damage. SVF has a quick onset and allows for ongoing improvement. Changes in lifestyle will stop and possibly reverse some more of the damage. Lifestyles changes are long term and vessel changes are slow but continuous.