Current Treatment Options in Acute Limb Ischemia

Fluck, Friederika; Augustin, Anne Marie; Bley, Thorsten Alexander; Kickuth, Ralph

doi:10.1055/a-0998-4204

Cited by 33 publications

(27 citation statements)

References 52 publications

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“…Emergency anticoagulation with unfractionated heparin, which prevents the proliferation of thrombosis and maintains microcirculation, is necessary [28]. In our study, 55.6% of APS-ALI patients exhibited thrombocytopenia, which is associated with a high risk of bleeding during anticoagulation and thrombolysis therapy.…”

Section: Discussionmentioning

confidence: 61%

Acute Lower Limb Ischemia in Antiphospholipid Syndrome: A Retrospective Cohort Study

Tang

Wang

et al. 2022

Preprint

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Acute lower limb ischemia (ALI) with antiphospholipid syndrome (APS) is a potentially fatal disease. We performed retrospective analysis of prospectively collected data from patients examined from January 2015 to January 2021 that were diagnosed with definite APS and ALI, and tested positive for antiphospholipid antibodies; had undergone computed tomographic angiography or color doppler ultrasound, and showed clinical manifestations. In total, 72 APS-ALI patients were enrolled in this cohort study. The patients were divided into two groups: the delayed APS diagnosis group (APS-d) (n=40) and the timely APS diagnosis group (APS-t) (n=32).72.2% patients showed relieved ischemia symptoms (APS-d vs APS-t, p=0.035), 27.8% patients showed recurrence of thrombosis, and 23.6%patients needed further surgery (APS-d vs APS-t, p=0.042). 37.5% APS patients were administered intravenous immunoglobulin (IVIG) (APS-d vs APS-t, p<0.01) and 34.8% were administered hormonotherapy (APS-d vs APS-t, p<0.01). The rate of amputation was 19.4% (APS-d vs APS-t, p=0.049) and the mortality rate was 16.6% (APS-d vs APS-t, p=0.033).Delayed diagnosis of APS in ALI patients was associated with a high risk of amputation and mortality. ALI patients who were diagnosed with APS early and underwent timely initiation of hormonotherapy, IVIG and anticoagulation, showed improved amputation and mortality.

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Section: Discussionmentioning

confidence: 61%

Acute Lower Limb Ischemia in Antiphospholipid Syndrome: A Retrospective Cohort Study

Tang

Wang

et al. 2022

Preprint

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“…Emergency revascularization is necessary for patients with acute limb ischaemia (ALI) that threatens the survival of the limb[ 7 ]. CDT is the preferred method of delivery for ALI[ 8 ], especially for ALI with a history of less than 14 d and without movement disorders[ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Critical lower extremity ischemia after snakebite: A case report

Lu¹,

Wang²,

Yan³

et al. 2021

WJCC

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BACKGROUND Globally, the estimated annual incidence of snakebites is approximately 5 million, and approximately 100000 deaths occur from snakebites annually. Local tissue reaction, haemorrhagic clotting disorder, nephrotoxicity, and neurotoxicity are very common effects of snake envenomation, but other rarer complications, such as thrombosis, may also occur as a result of underlying disease. In the treatment of snakebite patients, attention should be paid to the patient’s underlying diseases to avoid serious and catastrophic consequences secondary to snakebite. CASE SUMMARY We report a 69-year-old man with critical right lower extremity pain after left foot snakebite 10 d prior without intermittent claudication or atrial fibrillation history. He was diagnosed with acute right lower extremity arterial thrombosis, which may have been caused by coagulopathy after snakebite and lower extremity atherosclerotic occlusive disease. Lower extremity computed tomography angiography at another hospital revealed that the aortoiliac and femoral arteries had neither filling defects nor atherosclerosis, but the right popliteal artery was occluded 2.3 cm below the tibial plateau. The patient received emergency catheter-directed thrombolysis, but amputation was carried out 11 d after admission because the patient had been admitted to the hospital too late to save the extremity. CONCLUSION Acute ischaemia of the lower extremity due to snakebite is a rare event, and physicians should bear in mind the serious complications that may occur, especially in patients with atherosclerotic disease.

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“…Post-replantation follow-up is as important as the replantation process [2]. Metabolites in long-term ischemic tissue enter the venous system after replantation, which can lead to additional problems on a scale that can cause hyperkalemia, myoglobinuria, acute renal failure, and death [3][4][5]. For this reason, deciding on replantation and following a replanted patient is as difficult a process as the procedure itself [3][4][5].…”

Section: Introductionmentioning

confidence: 99%