Acute Limb Ischemia

Abstract

Acute limb ischemia is technically defined as ischemia of the lower extremities lasting 14 days or less. The condition affects between 15 and 26 persons per 100,000 each year in the United States. The associated morbidity and mortality is extremely high, with 1-year mortality rates reported at over 40%. Acute limb ischemia is 20 times more common in the lower extremities than the upper extremities. Both interventional radiologists and vascular surgeons bring unique skills to the table in caring for these patients, and therefore should approach the care of these patients in a multidisciplinary manner to ensure the best outcomes for each patient. Patients should be classified according to the Rutherford classification scale for acute limb ischemia. Catheter-directed thrombolysis can be a viable treatment alternative for these patients, offering a minimally invasive option to patients with outcomes similar to surgery. It is important to know the presentation, physical examination, risks and benefits, as well as the techniques and equipment required to treat patients with acute lower limb ischemia.

Keywords: Acute lower limb ischemia; catheter-directed thrombolysis; embolectomy; revascularization bypass; tPA infusion, arterial occlusion technique.