MSK: Chronic Limb Ischaemia: Free MSRA Podcast

🎧FREE MSRA PODCAST –Chronic Limb Ischaemia (CLI): Pain on the Pavement to Gangrene 🦵💥This high-yieldepisode takes you through the entire journey ofCLI, from risk factors to limb-saving interventions. Learn how to spotthe red flags, manage risk, and prevent serious complications — all MSRA exam-ready and clinically relevant. 🧠What You’ll Learn –CLI Simplified✅Definition• Chronic LimbIschaemia is severe peripheral arterial disease(PAD)• Marked by significantly reduced blood flow to the lowerlimbs, often with rest pain, ulcers, or gangrene 🚬Mnemonic: SAHOF –Risk FactorsS – Smoking 🚭A – Age (older adults, esp. >70)H –Hyperlipidaemia 🧈O – ObesityF – Family history of PADDiabetes, CKD, autoimmune disease = add-on risks 🔬Pathophysiology• Atheroscleroticplaque builds up → arterial narrowing• ↓ Blood flow → oxygen-starved tissues• → Pain, ulcers,tissue death if severe 🔍DifferentialDiagnoses• Acute limb ischaemia (urgent!)• DVT (vein issue)• Spinal stenosis, arthritis• Buerger’s disease, vasculitis 📈Epidemiology• ~1–2% of UKpopulation affected• ↑ Prevalence inelderly (esp. over 70s)• Slight malepredominance ⚠️Clinical Features –Mnemonic: “Pain on the Pavement”• Intermittent claudication – cramping onwalking, resolves with rest• Rest pain – burning, often in toes, worse atnight• Ulcers / gangrene – non-healing wounds• Cold limb, weak/absent pulses 🧪Key Investigations• ABPI (Ankle Brachial Pressure Index)–<0.5 = severe disease = CLI 🚨– >1.2 = mayindicate calcified vessels (diabetics, CKD)• Doppler ultrasound – first-line imaging• CTA / MRA – detailed mapping for surgery• Angiography – gold standard for planningrevascularisation• Bloods: FBC,U&Es, LFTs, HbA1c, Lipids 💊ManagementLifestyle:• 🚭 Smoking cessation – most important• 🥦 Healthy diet• 🚶‍♂️ Supervised exercise – encourages collateral circulationMedical:• 🩸 Antiplatelet (aspirin or clopidogrel)• 🌟 Statin – lipid control + plaque stability• 🎯 Manage BP and diabetes aggressivelySurgical / Interventional:• Considered for rest pain, ulcers, gangrene• Options: angioplasty, stenting,bypass• 💊 Naftidrofuryl oxalate – for claudication (not CLI) 📊Prognosis• Can improve with early diagnosis, risk factorcontrol, and treatment• But if untreated → risk of amputation, infection,cardiovascular events ☠️Complications –Mnemonic: WITCHW – Wounds (non-healing ulcers)I – InfectionT – Tissue necrosis / gangreneC – Cardiovascular risk (MI, stroke)H – Hindered mobility / QoL ↓ 📎More MSRA Resourcesfor CLI📝 Revision Notes:https://www.passthemsra.com/topic/chronic-limb-ischaemia-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/chronic-limb-ischaemia-flashcards/📖 Accordion Q&A Notes:https://www.passthemsra.com/topic/chronic-limb-ischaemia-accordion-qa-notes/🎯 Rapid Quiz:https://www.passthemsra.com/topic/chronic-limb-ischaemia-rapid-quiz/🦵 Quiz:https://www.passthemsra.com/quizzes/chronic-limb-ischaemia/ 🌐 Access even more FREE resources:📚PassTheMSRA.com🔓FreeMSRA.com Hashtags#MSRA#ChronicLimbIschaemia #PAD #MSRARevision #MSRAFlashcards #MSRAAccordions#VascularSurgery #ABPI #MSRAQuiz #PassTheMSRA #FreeMSRA#PeripheralArterialDisease