Acute limb ischaemia: Difference between revisions

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== Acute Limb Ischaemia ==


'''Acute limb ischaemia''' (ALI) is a sudden decrease in limb perfusion that threatens the viability of the limb. It is a medical emergency that requires prompt diagnosis and treatment to prevent limb loss and other serious complications.
{{Infobox medical condition
| name            = Acute limb ischaemia
| image          =[[File:Arterial_thrombosis_causing_cyanosis.jpg|thumb|Arterial thrombosis causing cyanosis]]
| caption        = Arterial thrombosis causing cyanosis
| field          = [[Vascular surgery]]
| symptoms        = [[Pain]], [[pallor]], [[pulselessness]], [[paresthesia]], [[paralysis]], [[poikilothermia]]
| complications  = [[Tissue necrosis]], [[gangrene]], [[amputation]]
| onset          = Sudden
| duration        = Hours to days
| causes          = [[Embolism]], [[thrombosis]], [[trauma]]
| risks          = [[Atrial fibrillation]], [[peripheral artery disease]], [[smoking]], [[diabetes mellitus]]
| diagnosis       = [[Doppler ultrasound]], [[angiography]]
| differential    = [[Deep vein thrombosis]], [[compartment syndrome]]
| treatment       = [[Anticoagulation]], [[thrombolysis]], [[surgery]]
| prognosis      = Variable, depends on time to treatment
| frequency      = Common in patients with [[cardiovascular disease]]
}}
Acute Limb Ischaemia


== Pathophysiology ==
[[File:Arterial_thrombosis_causing_cyanosis.jpg|thumb|Arterial thrombosis causing cyanosis]]
[[File:Acuteoccluisionaxartery.png|thumb|Acute occlusion of the axillary artery]]
[[File:Angiograph_before_and_after_thrombolytic_therapy_in_a_case_of_thrombosis_on_the_hand.png|thumb|Angiograph before and after thrombolytic therapy in a case of thrombosis on the hand]]


Acute limb ischaemia occurs when there is a sudden reduction in blood flow to a limb. This can be due to an [[arterial embolism]], [[arterial thrombosis]], or trauma. The lack of blood flow leads to tissue hypoxia and can result in tissue necrosis if not promptly treated.
'''Acute limb ischaemia''' (ALI) is a sudden decrease in [[blood flow]] to a limb, threatening its viability. It is a medical emergency that requires prompt diagnosis and treatment to prevent [[tissue necrosis]] and potential [[amputation]].


=== Causes ===
==Causes==
Acute limb ischaemia can result from several causes, including:


1. '''[[Arterial embolism]]''': This occurs when a blood clot or other debris travels through the bloodstream and lodges in a limb artery, blocking blood flow.
* [[Embolism]]: A blood clot or other debris travels through the bloodstream and lodges in a limb artery.
2. '''[[Arterial thrombosis]]''': This is the formation of a blood clot within a limb artery, often on top of an existing atherosclerotic plaque.
* [[Thrombosis]]: A blood clot forms in a limb artery, often due to underlying [[atherosclerosis]].
3. '''Trauma''': Direct injury to a limb artery can cause acute ischaemia.
* [[Trauma]]: Physical injury to a limb can damage blood vessels, leading to ischaemia.
* [[Aortic dissection]]: A tear in the [[aorta]] can extend into limb arteries, reducing blood flow.


== Clinical Presentation ==
==Symptoms==
The classic symptoms of acute limb ischaemia are often referred to as the "six Ps":


Patients with acute limb ischaemia typically present with the "six Ps":
* [[Pain]]
* [[Pallor]]
* [[Pulselessness]]
* [[Paresthesia]]
* [[Paralysis]]
* [[Poikilothermia]] (coolness)


* '''Pain''': Sudden and severe pain in the affected limb.
==Diagnosis==
* '''Pallor''': The limb may appear pale due to lack of blood flow.
Diagnosis of acute limb ischaemia involves a combination of clinical assessment and imaging studies. Common diagnostic tools include:
* '''Pulselessness''': Absence of a pulse in the affected limb.
* '''Paresthesia''': Numbness or tingling in the limb.
* '''Paralysis''': Weakness or inability to move the limb.
* '''Poikilothermia''': The limb may feel cold to the touch.


== Diagnosis ==
* [[Doppler ultrasound]]: To assess blood flow in the affected limb.
* [[Angiography]]: Provides detailed images of blood vessels to identify blockages.
* [[Magnetic resonance imaging]] (MRI) or [[computed tomography]] (CT) angiography: Non-invasive imaging techniques to visualize blood vessels.


Diagnosis of acute limb ischaemia is primarily clinical, supported by imaging studies. [[Doppler ultrasound]] can assess blood flow, while [[angiography]] can visualize the site and extent of the blockage.
==Treatment==
The treatment of acute limb ischaemia aims to restore blood flow and prevent tissue damage. Options include:


== Treatment ==
* [[Thrombolysis]]: Administration of drugs to dissolve blood clots.
* [[Surgical embolectomy]]: Removal of the embolus or thrombus through surgery.
* [[Bypass surgery]]: Creating a new pathway for blood flow around the blocked artery.
* [[Amputation]]: In severe cases where tissue death has occurred, amputation may be necessary.


The primary goal of treatment is to restore blood flow to the affected limb as quickly as possible. Treatment options include:
==Prognosis==
The prognosis of acute limb ischaemia depends on the severity and duration of the ischaemia, as well as the underlying cause. Prompt treatment can significantly improve outcomes and limb salvage rates.


* '''[[Thrombolysis]]''': Administration of clot-dissolving medications.
==Prevention==
* '''[[Surgical embolectomy]]''': Surgical removal of the embolus or thrombus.
Preventive measures focus on managing risk factors for vascular disease, such as:
* '''[[Bypass surgery]]''': Creating a new route for blood flow around the blockage.


== Prognosis ==
* [[Smoking cessation]]
 
* [[Blood pressure]] control
The prognosis of acute limb ischaemia depends on the speed of diagnosis and treatment. Delayed treatment can lead to [[limb amputation]] and other serious complications.
* [[Cholesterol management]]
 
* [[Diabetes management]]
== Related Pages ==


==Related pages==
* [[Peripheral artery disease]]
* [[Peripheral artery disease]]
* [[Chronic limb-threatening ischaemia]]
* [[Chronic limb-threatening ischaemia]]
* [[Vascular surgery]]
* [[Vascular surgery]]
* [[Thrombosis]]


== Gallery ==
[[Category:Vascular diseases]]
 
[[Category:Medical emergencies]]
<gallery>
<gallery>
File:Arterial_thrombosis_causing_cyanosis.jpg|Arterial thrombosis causing cyanosis
File:Arterial_thrombosis_causing_cyanosis.jpg|Arterial thrombosis causing cyanosis
File:Acuteoccluisionaxartery.png|Acute occlusion of the axillary artery
File:Acuteoccluisionaxartery.png|Acute occlusion of axillary artery
File:Angiograph_before_and_after_thrombolytic_therapy_in_a_case_of_thrombosis_on_the_hand.png|Angiograph before and after thrombolytic therapy
File:Angiograph_before_and_after_thrombolytic_therapy_in_a_case_of_thrombosis_on_the_hand.png|Angiograph before and after thrombolytic therapy in a case of thrombosis on the hand
</gallery>
</gallery>
[[Category:Vascular diseases]]
[[Category:Medical emergencies]]

Latest revision as of 03:28, 4 April 2025


Acute limb ischaemia
Arterial thrombosis causing cyanosis
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia
Complications Tissue necrosis, gangrene, amputation
Onset Sudden
Duration Hours to days
Types N/A
Causes Embolism, thrombosis, trauma
Risks Atrial fibrillation, peripheral artery disease, smoking, diabetes mellitus
Diagnosis Doppler ultrasound, angiography
Differential diagnosis Deep vein thrombosis, compartment syndrome
Prevention N/A
Treatment Anticoagulation, thrombolysis, surgery
Medication N/A
Prognosis Variable, depends on time to treatment
Frequency Common in patients with cardiovascular disease
Deaths N/A 


Acute Limb Ischaemia
Arterial thrombosis causing cyanosis
Acute occlusion of the axillary artery
Angiograph before and after thrombolytic therapy in a case of thrombosis on the hand

Acute limb ischaemia (ALI) is a sudden decrease in blood flow to a limb, threatening its viability. It is a medical emergency that requires prompt diagnosis and treatment to prevent tissue necrosis and potential amputation.

Causes[edit]

Acute limb ischaemia can result from several causes, including:

  • Embolism: A blood clot or other debris travels through the bloodstream and lodges in a limb artery.
  • Thrombosis: A blood clot forms in a limb artery, often due to underlying atherosclerosis.
  • Trauma: Physical injury to a limb can damage blood vessels, leading to ischaemia.
  • Aortic dissection: A tear in the aorta can extend into limb arteries, reducing blood flow.

Symptoms[edit]

The classic symptoms of acute limb ischaemia are often referred to as the "six Ps":

Diagnosis[edit]

Diagnosis of acute limb ischaemia involves a combination of clinical assessment and imaging studies. Common diagnostic tools include:

Treatment[edit]

The treatment of acute limb ischaemia aims to restore blood flow and prevent tissue damage. Options include:

  • Thrombolysis: Administration of drugs to dissolve blood clots.
  • Surgical embolectomy: Removal of the embolus or thrombus through surgery.
  • Bypass surgery: Creating a new pathway for blood flow around the blocked artery.
  • Amputation: In severe cases where tissue death has occurred, amputation may be necessary.

Prognosis[edit]

The prognosis of acute limb ischaemia depends on the severity and duration of the ischaemia, as well as the underlying cause. Prompt treatment can significantly improve outcomes and limb salvage rates.

Prevention[edit]

Preventive measures focus on managing risk factors for vascular disease, such as:

Related pages[edit]

  • Arterial thrombosis causing cyanosis
    Arterial thrombosis causing cyanosis
  • Acute occlusion of axillary artery
    Acute occlusion of axillary artery
  • Angiograph before and after thrombolytic therapy in a case of thrombosis on the hand
    Angiograph before and after thrombolytic therapy in a case of thrombosis on the hand
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