Society for Clinical Vascular Surgery
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Questions every patient should ask their doctor
prior to signing a consent for vascular intervention.

Sponsored by the SCVS Ad Hoc Committee on Patient Advocacy.

CRITICAL LIMB ISCHEMIA (CLI)

  1. Why do I have an ulcer?

    With CLI, arteries carrying blood away from the heart to the legs, become narrowed or blocked, reducing blood flow. When the blood supply is restricted, tissues and muscles cannot get enough oxygen and nutrients. Ulcers can occur when tissue dies or wounds do not heal because of poor blood flow. You may have had a minor injury that cannot heal because there is not enough oxygen and blood flow to the area.

  2. What should I do with diabetes?

    Having diabetes puts you at increased risk for vascular disease. It can also lead to kidney disease, blindness and nerve damage. Good control of diabetes with a careful diet and medication can improve wound healing. People with CLI and diabetes must pay special attention to caring for their feet and selecting footwear. When circulation is reduced, sores on the feet become easily infected and can take a long time to heal. To reduce the possibility of infection, inspect your feet and lower legs every day for cuts and breaks in the skin. Treat breaks in the skin promptly. Moisturizing your feet may decrease the number of breaks in the skin. Be careful in selecting footwear (both socks and shoes).

  3. Am I going to lose my leg?

    Once someone has critical limb ischemia (CLI) there is a possibility that you may lose your leg. In some cases, even with successful surgical treatment, amputation is done because of poor healing or continued pain. Sometimes angioplasty or open surgery only works for a short amount of time, but allows enough oxygen to get to the tissue to heal the ulcer and you may not lose your leg.

  4. What is bypass surgery?

    Arterial bypass is a surgical procedure that uses a graft to reroute circulation around the blocked area of the artery. The graft can be a vein taken from another part of your body, or it can be man-made. A synthetic graft resembles the shape of a vein. The graft is attached to the artery above and below the blocked area of the artery, allowing blood to go around the blockage. The blocked area is not removed.

  5. How about a stent for the circulation

    Procedures using catheters can treat blocked arteries. In angioplasty, a catheter with a tiny balloon at its tip is inserted into a blood vessel and inflated to open an artery. A stent can be placed during angioplasty. These procedures may be done at the same time as an arteriogram (x-rays of the arteries).

  6. Should I take any medications to heal the ulcer?

    Medications cannot cure peripheral arterial disease, but they can help treat conditions that can contribute to PAD, such as high cholesterol and triglycerides, high blood pressure and diabetes. If your doctor thinks your ulcer may be infected, he/she may prescribe an antibiotic to help control the infection.

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