What is critical limb ischemia?

Limb ischemia, also called critical limb ischemia, is a condition brought on by a sudden decrease in blood flow and oxygen to the legs, feet or hands. This severe condition is associated with peripheral artery disease (PAD) and is caused by blood being slowed or blocked by the build-up and hardening of plaque in the walls of the arteries (atherosclerosis).

People with limb ischemia may also have symptoms such as skin sores and wounds that won’t heal, or in some cases, gangrene (death of cells in the tissues of the limb). Other signs of limb ischemia include:

  • Severe pain in the legs, even while resting (“rest pain”)
  • Lack of pulse in hands, legs or feet
  • Shiny, smooth, dry skin on the legs or feet
  • Noticeable change in limb temperature compared to other parts of body
  • Toenail thickening

Limb ischemia is a medical emergency and requires immediate treatment in order to protect the limb from infection, blood clots, and amputation.

Diagnosis and testing for limb ischemia

To determine the cause and severity of your condition, your doctor may order vascular imaging, a peripheral arterial ultrasound, and blood pressure tests. If a blockage is found, you may also have an angiogram, which is an X-ray of the arteries.


Treatment options may include medication, or a combination of medication and minimally invasive, endoscopic surgery, such as angioplasty and stenting.

Percutaneous Transluminal Coronary Angioplasty (and Stenting)

Coronary angioplasty is a treatment for atherosclerosis, which you may need if diet and lifestyle changes aren’t enough to improve blood circulation to the heart. Learn more about what to expect during angioplasty and stenting procedure.

Vascular Surgery

Our surgeons perform hundreds of procedures to open blocked arteries and restore healthy blood flow with traditional open surgery as well as minimally invasive and endovascular interventions.