Critical Limb Ischemia Non-Responders
A statistically significant number of patients don’t respond to revascularization, the primary treatment for Critical Limb Ischemia. This elevates the risk of amputation and subjects patients to lifelong pain and suffering.
How prevalent is this, and what factors lead to it?
Critical limb ischemia (CLI) is a condition associated with blocked arteries of the lower limbs. It inhibits blood flow and can lead to thickened toenails and severe pain in the feet and toes.
CLI is a severe form of peripheral arterial disease or PAD. All PADs result from the hardening and constriction of lower limb arteries caused by a build-up of plaque (fatty deposits) in the affected blood vessels.
Symptoms and complications of CLI
Critical limb ischemia mostly manifests as ischemic rest pain (pain in the legs when a person is at rest). Other CLI signs include chronic wounds that don’t heal, dry and shiny skin of the feet or
legs and low, or absent pulse in lower limbs. Dry gangrene on the lower extremities is also a tell- tale sign of CLI. If left untreated, these symptoms worsen and may require an amputation of the affected leg.
Critical limb ischemia causative factors
CLI is caused by many factors top among them diabetes, a family history of atherosclerosis, and obesity/ overweight. You are at high risk of CLI if you have high blood pressure, high blood cholesterol, or lead a sedentary life.
Revascularization and recovery
Revascularization: The restoration of blood circulation to an organ affected by CLI. Current revascularization techniques are safe, minimally invasive, and crucial therapy for patients with
CLI. The treatment leads to relief within a few hours.
There are two forms of revascularization CLI therapiesendovascular and surgical.
Lately, endovascular therapy has become the mainstream acceptance primary therapy strategy against infrapopliteal vascular wounds in CLI patients.
The procedure is done under local anesthesia to clear blocked arteries and eliminate the plaque that obstructs blood flow. The result is reduced pain and minimized risk of tissue decay.
Endovascular revascularization is a quick procedure with faster recovery times.
Surgical revascularization involves the use of techniques such as angioplasty and stents. In angioplasty, a small balloon is inserted into the affected limb via a puncture in the groin. The
surgeon then inflates the tiny balloon using a saline solution to dilate the artery. If stents are used, metal mesh tubes are inserted following angioplasty to keep the artery from closing.
An advanced version of surgical revascularization uses a catheter with a spinning blade that physically removes the plaque. This is called directional atherectomy:
Critical Limb Ischemia Non-Responders:
CLI non-responders are patients who experience no significant relief following endovascular or surgical revascularization. This leads to complications such as chronic ulcers and wounds and repeated revascularization.
Risk factors for CLI Non-Responders
A new study published by the Sage Group identifies the below risk factors for revascularization non-response among CLI patients:
· Diabetic foot ulcers
· Foot artery disease
· Microvascular disease
Conclusion
Endovascular and surgical revascularization are critical therapies with substantive positive outcomes in patients with CLI. However, the probability of achieving a better result in CLI NonResponders is lower, leading to prolonged pain and suffering and high health care costs.
Washington Vascular Specialists provides the best level of clinical care for CLI patients and others with vascular disease. We boast a multidisciplinary team of medical experts that excel in designing advanced solutions for vascular problems.
We draw from decades of surgical experience and extensive approaches in diagnosing and treating CLI in both responders and non-responders.
