Acute_Limb_Ischemia-An_Update_on_Diagnosis_and_Management

What is acute limb ischemia (ALI)?

A severe condition characterized by a sudden decrease in limb perfusion that threatens limb viability, requiring prompt diagnosis and treatment.

What are the main causes of acute limb ischemia?

Arterial embolism (30%), arterial thrombosis due to plaque progression (40%), thrombosis of a popliteal aneurysm (5%), trauma (5%), and graft thrombosis (20%).

What is the classical mnemonic used to describe the clinical presentation of ALI?

The '6 Ps': pain, pallor, paralysis, pulse deficit, paresthesia, and poikilothermia.

What imaging technique is the first choice for assessing ALI?

Duplex ultrasound (DUS) is the first imaging choice due to its wide availability and non-invasive nature.

What does the Rutherford classification assess in ALI patients?

It grades the severity of ALI based on physical examination findings, including skin color, venous filling, motor and sensory function, helping to determine the prognosis.

What is the primary treatment for patients with ALI?

The treatment depends on the type of occlusion and may include endovascular techniques (thrombolysis, thrombectomy) or surgical revascularization.

What is the goal of catheter-directed thrombolysis (CDT) for ALI?

To restore blood flow to the affected limb as quickly as possible.

Why is immediate anticoagulation important in the management of ALI?

It prevents thrombus propagation and helps preserve microcirculation in the affected limb.

What are common post-procedural complications associated with ALI treatment?

Reperfusion injury, compartment syndrome, and potential need for amputation.

What are the long-term treatment recommendations for patients after ALI?

Long-term anticoagulation for thromboembolic patients, statin therapy for atherosclerotic lesions, and dual antiplatelet therapy after stent implantation.