Acute limb ischemia is a potentially life-threatening clinical event. Thrombosis in situ, bypass graft thrombosis, and embolic occlusion are the three major precipitating events leading to acute limb ischemia. Management of acute ischemia depends on the clinical status of the affected limb and patient comorbidities. Catheter-directed thrombolysis (CDT) is the treatment of choice for patients with relatively mild acute limb ischemia (Rutherford categories I and IIa) with no contraindications to thrombolytic therapy. Patients with severe acute limb ischemia (Rutherford category IIb) need emergent revascularization. CDT should be considered, nonetheless, if the relative risks compared with primary operation are favorable. CDT is a life-and limb-saving treatment for many patients despite limitations of efficacy and associated complications. This article is a review of the etiology of acute arterial occlusion; clinical triage of patients presenting with acute limb ischemia; catheter guide wire techniques, pharmacological agents, and devices in current use for CDT; as well as the outcomes of CDT.

The superfluid phase transition of the general vortex gas, in which the circulations may be any non-zero integer, is studied. When the net circulation of the system is not zero the absence of a superfluid phase is shown. When the net circulation of the vortices vanishes, the presence of off-diagonal long range order is demonstrated and the existence of an order parameter is proposed. The transition temperature for the general vortex gas is shown to be the Kosterlitz-Thouless temperature. An upper bound for the average vortex number density is established for the general vortex gas and an exact expression is derived for the Kosterlitz-Thouless ensemble.

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Power-injectable tunneled catheters with attached subcutaneous ports are safe with low rates of complication during placement and dwell time. Power injection of contrast through these ports may be as safe as power injection using other venous access methods.

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