Acute lower limb ischemia: pathogenesis and management.

Abstract

AbstractAcute lower limb ischemia continues to be a problem both in diagnosis and management. The high mortality rate appears to be related to the metabolic consequences of ischemia, a function not only of time, but also of severity. The etiology of acute ischemia is reviewed along with the pathophysiological response. The management of the patient centers on diagnosis of cause and estimation of the severity of ischemia. Correction of metabolic disturbances and early restoration of flow is the preferred treatment, although there remains a place for late operative intervention in patients with less severe symptoms. Despite improved diagnostic and operative techniques, the thrombotic and metabolic changes that occur in the small vessels and muscular tissues appear to limit the success rate, with mortality rates remaining around 25%.