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Chronic Limb Ischemia and Non-Healing Wound Treatment

What is Chronic Limb Ischemia (CLI)?

Chronic Limb Ischemia (CLI) is a severe form of peripheral artery disease (PAD) that occurs when blood flow to the limbs, usually the legs, becomes critically reduced. This poor circulation can cause significant pain, wounds that do not heal, and in severe cases, tissue death (gangrene). CLI is a serious condition that requires prompt medical attention to prevent amputation or limb loss .

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Signs and Symptoms of CLI

The hallmark of CLI is rest pain, where patients experience severe discomfort in the legs or feet even when resting. Other signs of CLI include:

  • Sores or ulcers on the legs or feet that do not heal
  • Blackened or discolored toes
  • Numbness or weakness in the legs
  • Gangrene or tissue death in the affected limb

Non-Healing Wounds and CLI

Non-healing wounds, particularly on the lower limbs, are often a result of poor circulation due to PAD or diabetes. These wounds are highly susceptible to infection and can lead to more serious complications, including amputation. Early intervention is critical to promoting healing and preventing severe outcomes.

Diagnosis of CLI and Non-Healing Wounds

  • Doppler Ultrasound: Used to assess the flow of blood in the arteries and locate blockages[3] .
  • Angiography: A more detailed imaging procedure that helps identify the location and severity of the arterial blockage.
  • CT Angiography (CTA): CTA combines X-ray imaging with computer technology to create detailed images of blood vessels. It is particularly useful for detecting blockages or narrowing in the arteries.
  • Magnetic Resonance Angiography (MRA): MRA is a specialized form of MRI that uses magnetic fields and radio waves to produce highly detailed images of blood vessels. Unlike CTA, MRA does not involve radiation, making it a good option for some patients. It is excellent for evaluating the severity of arterial blockages and planning treatments for CLI.

Treatment for Chronic Limb Ischemia and Non-Healing Wounds

Treatments for CLI are focused on restoring blood flow and preventing further tissue damage. We offer a range of interventional and and surgical options to improve circulation and heal wounds, including:

  • Endovascular Procedures: Minimally invasive techniques such as angioplasty and stenting to open narrowed or blocked arteries.
  • Bypass Surgery: In cases where endovascular techniques are not sufficient, bypass surgery can create a new route for blood to flow around a blocked artery.
  • Wound Care Management: Effective management of non-healing wounds requires a comprehensive approach, combining wound care therapies with vascular treatments to improve blood flow, including:
    • Debridement: Removal of dead or infected tissue to promote healing.
    • Specialized Dressings: Customized dressings that create an optimal environment for healing.
    • Hyperbaric Oxygen Therapy: A therapy that delivers oxygen under pressure to promote faster healing in tissues with poor blood flow.

 

In addition to these direct treatments, medical therapy plays a critical role in reducing the risk of disease progression and preventing future complications. This includes:

  • Antiplatelet Medications: To reduce the risk of blood clots.
  • Cholesterol-Lowering Drugs (Statins): To control plaque buildup and improve overall vascular health.
  • Blood Pressure Management: Ensuring blood pressure is controlled to prevent further arterial damage.
  • Diabetes Management: In patients with diabetes, controlling blood sugar levels is crucial to prevent further deterioration of wound healing.
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