Critical Limb Ischemia (CLI)

Quick answer

Critical limb ischemia is the severe end of peripheral artery disease. A narrowed or blocked artery leaves part of your body without enough blood and oxygen. In the legs, the giveaway is rest pain, severe pain in your feet or lower legs while you are sitting still, or sores that will not close. Skin turns shiny and dry, toenails thicken, pulses fade. It can cause gangrene and limb loss. It will not get better on its own.

Critical limb ischemia (CLI) is a serious condition in which there is inadequate blood flow and oxygen to a specific part of the body. It can occur anywhere blood flows including the limbs, heart, brain, or intestines. It is generally caused by a narrowing or blockage of an artery. Ischemia is serious form of peripheral artery disease that can cause tissue damage gangrene, ulcers & limb loss. CLI requires appropriate medical attention and will not improve on its own.

Critical limb ischemia (CLI) foot illustration

Peripheral artery disease (PAD) illustration

What are the symptoms of critical limb ischemia (CLI)?

The most common symptoms of CLI is called ischemia rest pain (severe pains in the lower limbs while a person is not moving0 and/or non-healing sores in the legs or feet.

Other signs and symptoms may include:

Pain or numbness in the feet
Shiny, smooth, dry skin of the legs or feet
Thickening of the toenails
Absent or diminished pulse in the legs or feet
Open sores, skin infections or ulcers that will not heal
Dry gangrene (dry, black skin) of the legs or feet

Primary risk factors of CLI:

Risk factors are similar to atherosclerosis which includes smoking, aging, hypertension (high blood pressure), high cholesterol, diabetes and a family history of vascular disorders: atherosclerosis and/or claudication.

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A little blonde Russian woman named Natasha asked me to post about her renal procedure. It was done by Dr. Khorsandi at CACVI. They took absolutely amazing care of her and went above and beyond to treat her terribly high blood pressure. They lasered her renal artery. After the procedure it wouldn’t stop bleeding so they ended up staying w her at the center until 9pm. That’s when they finally had to call the ambulance to move her to E.R. All of the staff were incredibly professional and their care was second to none. Dr. Lala promised her that her high blood pressure would go away. It has and now she’s throwing out all her old med’s just like Lala promised. This group of Doctors is like no other. If you have any of these cardiac issues then you’ve found your saving grace. No need to look any further. They were incredibly patient and helpful in every medical way possible. Natasha has found a new way of living. Without her terrible pounding migraines she had on a daily basis. 5 stars all the way. They deserve all the praise possible. They provided a miracle. Thank you Dr’s Lala & Khorsandi.

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On behalf of my father, a patient of CACVI, I wanted to acknowledge and praise the entire team of this organization for its outstanding surgical expertise and knowledgeable/warm supporting staff. We had gone through countless recommendations that all claimed there was only one last option for treatment, amputation. That news is devastating for anyone to hear, and resulted in my father having little faith that the quality of his life would ever be the same... All that changed the moment we had our first interaction with this organization. The care, knowledge, and most importantly hope that there was still options if we acted fast was single moment that turned this entire nightmare around. Thank you CACVI for being the single most important piece to solving my father's health crisis. Dont think twice, make the appointment and atleast go meet and see them-- for us it was the moment that changed the trajectory of our situation forever for the better.

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Matt Golad

I’m 41 years old, and I have something called May-Thurner’s Syndrome. However, it wasn’t until I saw Dr. Vasim Lala a couple years ago that I was diagnosed with it. May-Thurner’s syndrome is when the main veins that split off into your legs is compressed by the main arteries that split off into your legs. The result is that the blood that should be coming back up through the leg veins pools at your ankles. My whole life until I was diagnosed, I was lethargic. My legs felt heavy. I started to develop purple bruising around my ankles in my twenties. I started to get varicose veins on my calves. I thought this was normal. I was living on “hard mode” and didn’t know it. If I was on my feet for extended periods of time, my legs would swell a lot. I thought maybe I need to lose some weight. When I started teaching a few years ago, I would be on my feet 6-8 hours a day. One day, I got home, and my left leg was so swollen my wife was concerned I had a blood clot. I went to the emergency room, and thankfully it was just superficial. I temporarily went on blood thinners and was recommended to see Dr. Lala. He changed my life. I’d shown my purpling ankles to GP’s. They’d seen my varicose veins. But none if them put all the signs together until I saw Dr. Lala. He diagnosed me with May-Thurner’s syndrome and recommend we put stents in my veins to prevent them from being compressed by the arteries. So we did the surgeries. Out patient procedures. My legs stopped swelling a lot. I started wearing compression socks. I had to be on blood thinners for a year, but eventually I was able to stop taking them which was great. But I still had varicose veins in my legs because they had widened from the blood pooling in them for years. I’ve had two ablations per leg since them, which closes the affected veins, and I’ve got a new lease on life. My legs feel lighter. They don’t swell nearly as much. The varicose veins have disappeared. Now, I’m lighter on my feet. I’m not lethargic. There’s a pep in my step. I have one more ablation each being scheduled. I’m thankful for Dr. Lala and his incredible team at CACVI for their diagnosis and treatment. It truly changed my life.

4 months ago Tarzana Read on Google

PAK SHIP ALL

On August 27, 2025, I had my leg Angio done with Dr. K. who is best of the best. Amazing Doctor and extremely knowledgeable. The nurse who helped me, JULIAN she has a very kind heart. She has a lot of knowledge and made me feel extremely relaxed. She went above and beyond her responsibilities. It seems God made her to be kind and caring for all the patients. I salute her and look forward to having same nurse for procedure in my other leg. I came home with a big Smile. Thank you Thank you Thank you

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Dr. Moinakhtar Lala and Dr. Mehran J. Khorsandi of CACVI

Dr. M Lala, Dr. Mehran J. Khorsandi and Dr. V Lala

Meet Your Specialists

The Center for Advanced Cardiac and Vascular Interventions (CACVI) is led by Dr. M Lala, Dr. Khorsandi, and Dr. V Lala, who have over thirty years of practice with over 15,000 vascular and cardiac procedures performed. Our physicians are determined to provide each patient with experienced, compassionate care as they work diligently to improve your health.