Ischemia is a serious condition where a lack of blood flow and oxygen affects a specific area of the body. Critical Limb Ischemia is generally caused by a narrowing or blockage of an artery which can result in tissue damage and loss of limbs. This condition does not improve on its own and requires medical attention.
- Resting foot pain
- Numbness in the feet
- Shiny, smooth or dry skin on the legs or feet
- Thickening of the nails on your feet
- Weakened pulse in the legs or feet
- Open sores or ulcers that will not heal
- Gangrene (dry, blackened skin) on the legs or feet
The symptoms of ischemia depend on how quickly the blood flow is interrupted and where it occurs.
- Advanced age
- High cholesterol
- High blood pressure
- A family history of cardiovascular disease
- Sedentary lifestyle
Treatment of ischemia depends upon the location and its severity. However, for all forms of ischemia, controlling risk factors, especially smoking cessation, is critical. It may prevent progression of the ischemia and save your limb or your life. Treatment is focused upon getting more blood supply to the area of ischemia; ways we can do this include:
- Medications: Several medications may be prescribed to prevent further progression of the disease and to reduce the effect of contributing factors such as high blood pressure and cholesterol. Medications that fight infections, and pain medications may also be prescribed in certain cases.
- Exercise: A supervised exercise routine may be prescribed. Regular exercise may also result in other benefits such as weight loss, lower blood pressure, lower cholesterol, and better control of diabetes.
- Surgery or Endovascular Procedures: In many cases, an endovascular procedure may be performed within the artery using clot-busting drugs to dissolve clots (thrombolysis), a balloon to widen the artery (angioplasty), and/or a wire-reinforced stent which remains inside the artery serving as a scaffolding to keep it open. In some cases, a bypass of the affected artery may be performed. Either a segment of leg vein or an artificial tube is attached surgically above and below the blockage to detour blood flow around the blocked area allowing the blood to reach the area of ischemia beyond the blockage. Severe blockages in the carotid arteries that lead to ischemia may be treated with a surgical procedure known as carotid endarterectomy in which severe plaque is removed from the artery.