Chronic Limb Ischemia is the most severe form of peripheral artery disease, characterized by blocked arteries and poor supply of oxygenated blood, to the extremities, such as arms and legs. Although initial symptoms are very subtle, through some of the general complaints reported so far; pain, burning as well as muscle cramping should be noted as initial signs. However, if ignored for a longer period of time, the condition can be aggravated to the phase, where an individual may experience pain when at rest; it should also be noted that the condition may lead to a severe side effect, like gangrene. Moreover, up to 40% patient may have to go through the anguish of amputation of lower limbs.
With reduced life expectancy, ever-increasing pain quotient and the limited option of mobility; a person with critical limb ischemia may hugely be affected with impaired physical, emotional as well as social health. Thus, we have come up with the brief compilation of what critical limb ischemia is? And how can it be managed to the extent of reduced pain and cessation of progression?
Risk factors for CLI patients:
Diabetes increases the risk of developing CLI by up to three times. Diabetic patients are also more prone to infections which can increase the incidence of foot ulcers. They usually have a reduced pain perception due to peripheral neuropathy and will have non-healing sores or ulcers. This further increases their chances of a leg amputation.
Cigarette smoking contributes to 75% of the peripheral artery disease cases. Cigarette smoke contains nicotine and carbon monoxide that can contribute to buildup in the arteries. Studies have shown that quitting smoking can reduce the risk of developing cardiovascular diseases.
Hypertension or high blood pressure can put excessive pressure on the blood vessels which gradually leads to narrowing of the arteries. It has been associated with stroke and cardiac diseases. CLI management with drugs for hypertension has been one route of therapy.
Dyslipidemia is a lifestyle factor occurring due to abnormal blood lipid profile including high total cholesterol levels, high level of triglycerides and low-density lipoprotein (LDL) and low levels of high-density lipoprotein (HDL). It is linked with obesity and can certainly be controlled through diet.
Obesity may directly or indirectly contribute to the development of chronic limb ischemia. It is linked with hypertension, high cholesterol levels. Research has shown that obese people have an inflammatory response in their body which can occlude their arteries. It worsens the complications associated with CLI and can also slow down the healing process of bodies.
Hence, bringing lifestyle modifications by quitting smoking, losing weight and dietary control can be definitely a practical approach to reduce the risk of developing CLI. In some advanced or untreatable cases, however, it is beyond our scope to prevent the progression of disease. Stem cell therapy is a promising approach in treatment of CLI. Stem cells aid in restoring blood supply which is lost in ischemic patients and prevent the need for amputation.