Chronic limb-threatening ischemia (CLTI)
In CLTI, blood flow is so low that the foot hurts even at rest, often at night, or wounds cannot heal. Without treatment to restore blood flow, the risk of amputation is high. Restoring circulation is the key step in limb salvage.
When to get help now: Black toes, spreading infection or sudden severe pain need same-day care.
Warning signs
- Foot pain at night that improves when you hang your leg off the bed
- Wounds on the toes or heel that won't heal
- Dark or black skin on the toes
Who is at risk
- People with PAD, diabetes or kidney failure
- Current smokers
How we treat it
Endovascular revascularization
Minimally invasive procedures to reopen blocked leg arteries: angioplasty, stenting and atherectomy.
Limb salvage surgery
Surgical bypass, infected bone removal and foot reconstruction to avoid major amputation.
Advanced wound care
Debridement, specialized dressings, negative pressure therapy and skin substitutes.
Medically reviewed by: [Clinician name, credentials] · Last reviewed: [date]