Critical Limb Ischemia (CLI) and Peripheral Artery Disease (PAD): The Urgent Facts You Need to Know

Peripheral Artery Disease (PAD) is a serious health concern that affects millions of Americans, yet often goes undiagnosed or untreated. It involves a blockage of arteries in the lower extremities that can ultimately lead to potential amputation if not addressed.

Understanding PAD and CLI

Peripheral Artery Disease (PAD) is an arterial blockage in the lower extremities. While 12%-20% of Americans aged 60 and older are affected by PAD, alarmingly, 20%-50% of people with PAD show no visible symptoms. Overall, 8–20 million Americans are affected by PAD.

Critical Limb Ischemia (CLI) is a severe form of PAD. It's a severe blockage of the arteries that significantly reduces blood flow to the extremities, causing severe pain and skin sores or ulcers.

Why the Urgency? Diabetes and Amputation Risks

The link between diabetes and severe limb issues is clear and urgent:

• Diabetes Prevalence: Over 30 million Americans have diabetes.

  
  

• PAD Risk in Diabetics: One in three people over age 50 with diabetes likely has PAD.

  
  

• Amputation Frequency: A lower limb (or part of a lower limb) is lost to amputation every 30 seconds as a consequence of diabetes.

  
  

• Amputation Statistics: Of the 2 million Americans who suffer from amputation, 54% are due to peripheral artery disease or diabetes.

  
  

• Secondary Amputation: For persons with diabetes who have a lower extremity amputation, up to 55% will require amputation of the second leg within 2–3 years.

  
  

• Mortality: Only 50% of PAD amputees survive more than 5 years. Furthermore, diabetic foot ulcers double the mortality rate and risk of heart attack, and increase the risk of stroke by 40%.

If a patient has CLI and doesn't receive revascularization (a procedure to restore blood flow), up to 40% will require a lower limb amputation within one year. Alarming Treatment Trends

A significant number of patients are not receiving necessary diagnostic and preventative care:

• Undiagnosed Blockages: A recent study of over 20,000 Medicare patients receiving amputations showed that 54% did not receive any vascular procedure, including a diagnostic angiogram.

  
  

• Low Diagnostic Rate: Only 1 in every 5 people who have been amputated received a diagnostic peripheral angiogram.

  
  

• ABI Test: Only 50% of patients have an Ankle-Brachial Index (ABI) test done, a simple, non-invasive test to check for PAD.

  
  

• Unhealed Wounds: For patients seeking care for CLI wounds, 33% die unhealed.

When Should You Get Diagnostic Testing?

Peripheral vascular diagnostic testing is crucial if you fall into any of the following categories:

• Diabetics: Especially those over 50 years old.

  
  

• Smokers: People who smoke or have a history of smoking are 4x more likely to have PAD.

  
  

• Symptoms: People experiencing pain, coldness, change in color, or numbness in their lower extremities.

  
  

• Slow-Healing Wounds: People with sores or wounds in their lower extremities that heal slowly or fail to heal.

If you are at risk or experiencing symptoms, talk to your doctor about screening for PAD. Early detection and treatment can save your limb and potentially your life.