Chronic limb threatening ischemia clti also referred to as critical limb ischemia cli and limb threat is an advanced stage of peripheral artery disease pad it is defined as a triad of ischemic rest pain arterial insufficiency ulcers and gangrene. Critical limb ischemia cli is a severe blockage in the arteries of the lower extremities which markedly reduces blood flow it is a serious form of peripheral arterial disease or pad but less common than claudication pad is caused by atherosclerosis the hardening and narrowing of the arteries . Ischemia can occur in any muscle group organ or tissue in the body for example in the lower extremities ischemia can cause claudication in peripheral artery disease pad or may cause critical limb ischemia cli in severe cases. Critical limb ischemia cli is a severe obstruction of the arteries which markedly reduces blood flow to the extremities hands feet and legs and has progressed to the point of severe pain and even skin ulcers or sores the pain caused by cli can wake up an individual at night. Critical limb ischemia cli defined as chronic ischemic rest pain ulcers or gangrene attributable to objectively proven arterial occlusive disease is the most advanced form of peripheral arterial disease traditionally open surgical bypass was the only effective treatment strategy for limb revascularization in this patient population
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