Critical Ischemia with Viability Threatened: Fibrinolysis Salvage Alternative with Ateplase; Case Report

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Introduction: arterial ischemia defined as stenosis or occlusion of the aorta either of distant arteries from the heart, is a vascular emergency with a high risk of loss of a limb and associated morbidity and mortality [1]. Clinical Case: A 79-year-old male patient with a clinical history of psoriasis and chronic pain in the lower limbs followed by rheumatology, with a previous 60-year smoking habit of 10 units daily, who attended the emergency department with severe pain in the right lower limb with paresthesias that make it impossible to walk for 6 hours after lifting weights at home. On physical examination the right lower extremity, intense pain on palpation, cold, femoral pulse, popliteal present, anterior and posterior tibial absent, decreased mobility, absent foot sensation. Discussion: In this particular case, it is noteworthy that the only risk factor that the patient presented for developing critical ischemia with threatened viability was smoking and as a salvage measure, fibrinolysis with ateplase was performed, monitoring the distal circulation with a positive response of arterial reperfusion distal. Conclution: It should be noted that as a salvage measure evaluating the patient's risk-benefit, fibrinolysis with ateplase can be performed. It is essential to establish an early diagnosis that allows timely therapy to be established and has a positive impact on the prognosis of these individuals, since they present a high rate of morbidity and mortality [4].