Evaluation and Management of Acute Limb Ischemia
Reviewing the etiology, clinical factors, and management options.
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Acute limb ischemia (ALI) occurs due to the sudden cessation of arterial perfusion to an extremity. It is a common yet potentially devastating pathology occurring in 22 to 26 per 100,000 patients annually.
1 Compared with critical limb ischemia, ALI is associated with a higher amputation and mortality rate. As a result, rapid diagnosis and therapy are critical for the management of these patients.
Open surgical revascularization has been the mainstay of therapy; however, over the last several years, many percutaneous technologies have emerged that have provided alternative modalities of restoring perfusion. Despite these newer catheter-based techniques, the management of ALI remains particularly challenging because amputation rates are variable and range from 15% to 20% (despite therapy) and mortality rates approach 26% at 1 year.