A PROSPECTIVE STUDY ON ACUTE LIMB ISCHEMIA - PRESENTATION, MANAGEMENT, OUTCOME- OUR INSTITUTIONAL EXPERIENCE

Abstract

Introduction:Acute limb ischemia (ALI) a major vascular emergency defined as sudden decrease in limb perfusion that threatens limb viability. Prompt early recognition and management is need of hour to reduce the morbidity and mortality associated with ALI. The aim of this study is to emphasis on presentation, management and outcome of ALI for better understanding of disease and management Materials And Method: 1. Period Of Study - 10months from OCT 2021 - JULY 2022 2. Total No Of Patients – 100 3. Study method – prospective observational study Results: The study enrolled 100 patients with sudden onset of six Ps (pain, pallor, poikilothermia, pulselessness, paresthesia, paralysis) and treated within 14 days of onset. Mean age group was 47.32 (18-80yrs) and 72% were male and 28% female, among which 66% were lower limb and 34% upper limb ALI. 26%class I, 18% class IIa, 32%class IIb, 24% class III. All patients were primarily treated with anticoagulation and 26 recovered. 36 patients had systemic lytic therapy with inj. Alteplase. 13 CDT were performed. 23 patients underwent thrombo/embolectomy with a balloon catheter (Fogarty). 15 patients underwent surgical bypass following lytic therapy and had successful revascularization of limb. 39 patients finally ended up with amputation in spite of intervention. 4 patients died and all 4 had saddle embolus with B/L LL ALI. Conclusion: In patients presenting with ALI, Major limb salvage ability factors – type and class of ischemia, etiogical factor, time of presentation to vascular specialist.Time is essence in salvaging the limb in ALI – act FAST.Class III ALI interventions have limb salvage ability rate of 17%, reduced the level of amputation and promotes stump healing- decreasing the morbidity.