Acute limb ischaemia
Acute limb ischaemia is a sudden decrease in limb perfusion that causes a time-critical threat to limb viability.
•Acute limb ischaemia may be due to thrombosis, embolism, or rarely Dissection
Recent myocardial infarction
Large vessel aneurysmal disease
Prior lower extremity revascularization
Risk factors for aortic dissection
Deep vein thrombosis
pain, pallor, pulselessness, paraesthesia and paralysis.
Angiography in OT
1-In the ED treatment would include:
Correction of dehydration with IV fluids
Keeping the patient NBM in anticipation of further intervention
2-Definitive treatment would depend on the viability if the limb, aetiology and location of the lesion, surgical preference and patient suitability for surgery:
-Peripheral occlusions in a viable limb may be managed by catheter directed thrombolysis, whereas revascularisation of the threatened limb is more time critical.
-Surgical options include:
Embolectomy (catheter or open)
Bypass (if arterial thrombosis present)
-Treatment of the non-viable limb is amputation.