Acute limb ischaemia

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

✓Risk factors:

Atrial fibrillation

Recent myocardial infarction

Aortic atherosclerosis

Large vessel aneurysmal disease

Prior lower extremity revascularization

Risk factors for aortic dissection

Arterial trauma

Deep vein thrombosis

pain, pallor, pulselessness, paraesthesia and paralysis.

✓diagnosis :
Duplex ultrasonography

CT angiography

Angiography in OT

✓management :

1-In the ED treatment would include:

Correction of dehydration with IV fluids

Keeping the patient NBM in anticipation of further intervention


IV heparin

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.