Quality Improvement Guidelines for Percutaneous Management of Acute Lower-extremity Ischemia

Patel, Nilesh H.; Krishnamurthy, Venkataramu N.; Stanley, Kim; Saad, Wael E.A.; Ganguli, Suvranu; Walker, T. Gregory; Nikolic, Boris

doi:10.1016/j.jvir.2012.09.026

Cited by 65 publications

(64 citation statements)

References 109 publications

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“…The causes of acute limb ischemia in patients who do not have atherosclerosis include artery damage due to the accident, aortic dissection, bakers cyst, popliteal entrapment and vasospasm. 6,9 The induction incidence of thrombosis and embolism, which are the cause of acute limb ischemia, accounts for 85% and 15% of cases respectively. 5 Relatively low levels of fibrin and erythrocytes exemplify the characteristics of arterial thrombosis, and instead it is mainly white thrombi composed of platelets, and occurs at the site where an atherosclerotic plaque rupture occurred due to high shear stress.…”

Section: Discussionmentioning

confidence: 99%

“…5,9 However, aspiration thrombectomy can induce distal embolism so the procedure should be performed carefully. In this case, the patient had acute limb ischemia caused by complete occlusion in the …”

Section: Discussionmentioning

confidence: 99%

“…1,5,9 In the current aging society Acute limb ischemia (ALI) is a serious condition requiring prompt intervention due to a sudden decrease in limb perfusion threatening limb viability. Treatment of ALI depends on the clinical status of the affected limb and patient comorbidities.…”

Section: 8mentioning

confidence: 99%

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Endovascular treatment of acute limb ischemia due to thrombotic occlusion of the suprainguinal artery

Kang

Bae

Nah

et al. 2016

KMJ

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Acute limb ischemia can have 6P symptoms like pain, paralysis, paresthesia, pulselessness, pallor and poikilothermia, and if the imminent situation of tissue loss such as gangrene in the lower extremity occurs it may threaten limb viability. 1-3The incidence of acute limb ischemia is about 14 people among 100,000 people per year, and the mortality rate within 30 days is approximately 15% and the amputation rate within 30 days is 10 to 30%. 4 The most common causes of acute artery occlusion are thrombosis and embolism occurring in the underlying atherosclerotic lesion. 5,6 Risk factors of arterial thrombosis include smoking, hypertension, diabetes, dyslipidemia, obesity, age, hyperhomocysteinemia and specific hypercoagulable state. 7,8The treatment of acute limb ischemia includes drug therapy using anticoagulation therapy, a percutaneous endovascular procedure and a surgical reperfusion procedure, while additional therapies during the percutaneous endovascular procedure include catheter directed thrombolysis, aspiration thrombectomy and mechanical thrombectomy. 1,5,9 In the current aging society Acute limb ischemia (ALI) is a serious condition requiring prompt intervention due to a sudden decrease in limb perfusion threatening limb viability. Treatment of ALI depends on the clinical status of the affected limb and patient comorbidities. Surgical therapy has been the historical standard of care for restoring limb perfusion; however, percutaneous endovascular intervention has been shown to be a promising treatment option in selected patients of ALI at high surgical risk. We report on a case of a 75-year-old man with ALI caused by thrombotic occlusion of the suprainguinal artery, successfully treated with endovascular therapy including stent insertion and thrombus aspiration and catheter-directed urokinase infusion in view of the clinical findings and imaging studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Endovascular treatment of acute limb ischemia due to thrombotic occlusion of the suprainguinal artery

Kang

Bae

Nah

et al. 2016

KMJ

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“…Revascularization of such limbs is futile and can actually be counter-productive due to associated high risk of reperfusion related organ dysfunction and death [4]. Such patients require planned amputation after initial stabilization.…”

Section: Treatment Selectionmentioning

confidence: 99%

“…The documented global incidence of ALI is 1.5 cases per 10,000 population per year. The reported major amputation rate after ALI is 10-15% [2,3], while the associated 30-day mortality is 15-25% [4].…”

Section: Introductionmentioning

confidence: 99%

Atraumatic Acute Limb Ischemia: Clinical Presentation, Classification, Assessment and Management- A Review

Gunawansa¹

2017

Int J Vasc Surg Med

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Acute Limb Ischaemia (ALI) can be a devastating clinical emergency with potentially life or limb threatening consequences. The commonest aetiologies of ALI are traumatic, embolic or thrombotic. While traumatic ALI is fairly obvious in the trauma victim, embolic and thrombotic ALI may mimic other clinical conditions such as neurological disease which may cause delays in diagnosis. Immediate diagnosis, accurate assessment of limb viability and urgent intervention when needed play a crucial role in salvaging the affected limb and preventing a major amputation. Delay in diagnosis and intervention causes irreversible muscle ischaemia leading to eventual limb loss and potential systemic organ dysfunction due to associated lactic acidosis and other toxins.

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Acute Limb Ischemia

Aoi

Kakkar

2023

Endovascular Interventions

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Quality Improvement Guidelines for Percutaneous Management of Acute Lower-extremity Ischemia

Cited by 65 publications

References 109 publications

Endovascular treatment of acute limb ischemia due to thrombotic occlusion of the suprainguinal artery

Endovascular treatment of acute limb ischemia due to thrombotic occlusion of the suprainguinal artery

Atraumatic Acute Limb Ischemia: Clinical Presentation, Classification, Assessment and Management- A Review

Acute Limb Ischemia

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