Abstract
Acute limb ischemia is a urgent condition which occurs when there is an abrupt interruption of blood flow into an extremity usually because of either embolic or thrombotic vascular occlusion. Restoration of perfusion through early intervention can decrease amputation and mortality. Contemporary treatment includes both surgery and endovascular techniques. There is a rapid progress in endovascular intervention therapy. This article aims to make a comprehensive review of the endovascular intervention options of acute limb ischemia.
Highlights
Acute limb ischemia (ALI) of the lower extremities remains a challenging clinical dilemma, which occurs when there is an abrupt interruption of blood flow into an extremity usually because of either embolic or thrombotic vascular occlusion [1,2]
There are three management options in acute lower limb ischemia: 1) clot removal by catheter-directed thrombolysis with or without percutaneous mechanical thrombectomy; 2) surgical thromboembolectomy followed by correction of underlying arterial lesions; and 3) anticoagulation with continued observation
More and more interventional therapies for ALI which derive from combinations of several procedures above are used to restore blood flow quickly and reduce complications
Summary
Acute limb ischemia (ALI) of the lower extremities remains a challenging clinical dilemma, which occurs when there is an abrupt interruption of blood flow into an extremity usually because of either embolic or thrombotic vascular occlusion [1,2]. There are three management options in acute lower limb ischemia: 1) clot removal by catheter-directed thrombolysis with or without percutaneous mechanical thrombectomy; 2) surgical thromboembolectomy followed by correction of underlying arterial lesions; and 3) anticoagulation with continued observation. In patients with the same level of ischemia (I), i.e., active patients without significant comorbidities, it is practical to proceed directly with endovascular revascularization (CDT and, possibly, percutaneous mechanical thrombectomy). This same management choice is appropriate for those at level IIA, and at both of these levels of ischemia there should be sufficient time for restoration of patency using either endovascular or open surgical techniques [8].
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