Critical Limb Ischemia: A Practical Up-To-Date Review

Angiology. 2018 Jul;69(6):465-474. doi: 10.1177/0003319717739387. Epub 2017 Nov 21.


Critical limb ischemia (CLI) is the most advanced form of peripheral artery disease. It is associated with significant morbidity and mortality and high management costs. It carries a high risk of amputation and local infection. Moreover, cardiovascular complications remain a major concern. Although it is a well-known entity and new technological and therapeutic advances have been made, this condition remains poorly addressed, with significantly heterogeneous management, especially in nonexperienced centers. This review, from a third-level dedicated inpatient and outpatient cardioangiology structure, aims to provide an updated summary on the topic of CLI of its complexity, encompassing epidemiological, social, economical and, in particular, diagnostic/imaging issues, together with potential therapeutic strategies (medical, endovascular, and surgical), including the evaluation of cardiovascular risk factors, the diagnosis, and treatment together with prognostic stratification.

Keywords: CLI; LEAD; WIfI; arterial stiffness; intermittent claudication; peripheral arterial disease.

Publication types

  • Review

MeSH terms

  • Humans
  • Ischemia / diagnosis*
  • Ischemia / etiology
  • Ischemia / therapy*
  • Lower Extremity / blood supply*
  • Peripheral Arterial Disease / diagnosis*
  • Peripheral Arterial Disease / etiology
  • Peripheral Arterial Disease / therapy*