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Evaluation and Management of Acute Limb Ischemia Reviewing the etiology, clinical factors, and management options. Created with Sketch. 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.

United statesCzech republicMichaelc siahGunawansan atraumaticMichael shihPenumbra incBoston scientific corporationDepartment of surgeryThrombolex incUt southwestern medical centerWalk vascularViabahn gore associatesControl medical technologyPenumbra engineClot detectPower pulse