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Review
. 2019 Aug 14;8(8):1215.
doi: 10.3390/jcm8081215.

Acute Limb Ischemia: An Update on Diagnosis and Management

Dan-Mircea Olinic  1   2 , Agata Stanek  3 , Dan-Alexandru Tătaru  4   5 , Călin Homorodean  1   2 , Maria Olinic  1   2
Affiliations
Review

Acute Limb Ischemia: An Update on Diagnosis and Management

Dan-Mircea Olinic et al. J Clin Med. .

Abstract

This review presents an update on the diagnosis and management of acute limb ischemia (ALI), a severe condition associated with high mortality and amputation rates. A comprehensive spectrum of ALI etiology is presented, with highlights on embolism and in situ thrombosis. The steps for emergency diagnosis are described, emphasizing the role of clinical data and imaging, mainly duplex ultrasound, CT angiography and digital substraction angiography. The different therapeutic techniques are presented, ranging from pharmacological (thrombolysis) to interventional (thromboaspiration, mechanical thrombectomy, and stent implantation) techniques to established surgical revascularization (Fogarty thrombembolectomy, by-pass, endarterectomy, patch angioplasty or combinations) and minor or major amputation of necessity. Postprocedural management, reperfusion injury, compartment syndrome and long-term treatment are also updated.

Keywords: acute limb ischemia; diagnosis; duplex ultrasound; endovascular; mechanical thrombectomy; surgical revascularization; thromboaspiration; thrombolysis.

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Conflict of interest statement

The authors declare no conflict of interest.

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