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Chronic limb threatening ischaemia (CLTI)

saving limbs, saving lives

Chronic limb threatening ischaemia (CLTI) develops when the blood supply to the leg is severely compromised. This results in pain in the affected leg at rest and sometimes tissue loss (gangrene). These patients need an urgent review by the vascular team to see if they can be helped by revascularisation. There are daily urgent assessment clinics across the city set up  to permit this. Patients with super added infection may require emergency admission for control of sepsis and then further management.

Chronic limb threatening ischaemia (CLTI): About Us

Which patients should be referred to this service?

Consider referring patients with

  • severe lower limb rest pain

  • tissue loss below the ankle

to the CLTI service  via Vascular RAS using the CLTI referral proforma.

When should another service be used?

Patients with

  • evidence of foot sepsis

  • sudden onset of severe symptoms  suggestive of acute limb ischaemia (pain, paraesthesia, paralysis, perishing cold, pulselessness, pallor)


should be referred to emergency vascular service via 0121 424 2000 for further immediate assessment.


Patients with

  • leg ulcers should be referred to the Birmingham Vascular Centre via the leg ulcer service.

Who can make the referral?

We accept referrals from GPs, hospital specialists and other health care professionals such as tissue viability nurses, district nurses and podiatrists.

Further reading

CLTI patient information leaflet
Chronic limb threatening ischaemia (CLTI): List
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