Chronic Critical Limb Ischemia (CCLI) occurs in peripheral arterial disease when there is insufficient blood flow to the lower extremity at rest.


Criteria for the diagnosis of CCLI in the lower extremity:

(1) persistent, recurring ischemic pain in the lower extremity at rest

(2) need for opiate analgesia for >= 14 days

(3) non-healing ulceration or gangrene of toe or foot

(4) ankle to brachial index (ABI) < 0.40

(5) markedly reduced systolic blood pressures (toe systolic blood pressure < 30 mm Hg; ankle systolic blood pressure < 50 mm Hg)

(6) absent pedal pulses with a flat pulse volume waveform


A patient with CCLI requires an intervention to restore blood flow or else will require amputation.


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