[Acute limb ischemia]
- PMID: 29926571
[Acute limb ischemia]
Abstract
Despite major advances in the contemporary management of peripheral arterial occlusive disease, acute ischemia of the lower limb is still characterized by an important morbidity, limb threat, and mortality, and continues to pose a challenge to the vascular surgeon. Ageing of the population increases the prevalence of acute lower limb ischemia. The two principal etiologies of acute ischemia of the lower limbs are arterial embolism and in situ thrombosis of an atherosclerotic artery or of a bypass graft. Popliteal aneurysm thrombosis and vascular trauma are less common causes of severe limb ischemia. Prompt recognition and treatment of acute limb ischemia in an urgent setting are crucial, in order to shorten as much as possible the duration of the ischemia. This paper highlights diagnostic work-up (staging of the severity of ischemia) and appropriate management of acute ischemia of the lower limb. Different procedures of revascularization (operative clot removal, catheter-directed thrombolysis, bypass grafting are evaluated and their outcome results are compared.
Malgré les progrès considérables dans la prise en charge de la pathologie vasculaire, l’ischémie aiguë de membre inférieur reste grevée d’une morbidité et d’une mortalité importantes. La fréquence d’ischémie aiguë de membre augmente avec le vieillissement de la population. Les deux causes principales sont l’embolie artérielle et la thrombose d’une artère athéromateuse ou d’un pontage. Le délai de la prise en charge d’une ischémie de membre inférieur doit rester le plus court possible. Le diagnostic et la prise en charge optimale sont discutés. Les méthodes de revascularisation et les résultats sont décrits.
Keywords: Thrombosis; Arterial doppler – Fibrinolysis – Embolectomy – Vascular bypass.
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