Acute limb ischaemia: Difference between revisions

Revision as of 22:01, 11 February 2025

Acute Limb Ischaemia

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

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

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

Diagnosis

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

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.

Treatment

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

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

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

Related pages

@@ Line 1: / Line 1: @@
-== Acute Limb Ischaemia ==
+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.
+[[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]]
-== Pathophysiology ==
+'''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]].
-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.
+==Causes==
+Acute limb ischaemia can result from several causes, including:
-=== Causes ===
+* [[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.
-. '''[[Arterial embolism]]''': This occurs when a blood clot or other debris travels through the bloodstream and lodges in a limb artery, blocking blood flow.
+==Symptoms==
-. '''[[Arterial thrombosis]]''': This is the formation of a blood clot within a limb artery, often on top of an existing atherosclerotic plaque.
+The classic symptoms of acute limb ischaemia are often referred to as the "six Ps":
-. '''Trauma''': Direct injury to a limb artery can cause acute ischaemia.
-== Clinical Presentation ==
+* [[Pain]]
+* [[Pallor]]
+* [[Pulselessness]]
+* [[Paresthesia]]
+* [[Paralysis]]
+* [[Poikilothermia]] (coolness)
-Patients with acute limb ischaemia typically present with the "six Ps":
+==Diagnosis==
+Diagnosis of acute limb ischaemia involves a combination of clinical assessment and imaging studies. Common diagnostic tools include:
-* '''Pain''': Sudden and severe pain in the affected limb.
+* [[Doppler ultrasound]]: To assess blood flow in the affected limb.
-* '''Pallor''': The limb may appear pale due to lack of blood flow.
+* [[Angiography]]: Provides detailed images of blood vessels to identify blockages.
-* '''Pulselessness''': Absence of a pulse in the affected limb.
+* [[Magnetic resonance imaging]] (MRI) or [[computed tomography]] (CT) angiography: Non-invasive imaging techniques to visualize blood vessels.
-* '''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 ==
+==Treatment==
+The treatment of acute limb ischaemia aims to restore blood flow and prevent tissue damage. Options include:
-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.
+* [[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.
-== Treatment ==
+==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.
-The primary goal of treatment is to restore blood flow to the affected limb as quickly as possible. Treatment options include:
+==Prevention==
+Preventive measures focus on managing risk factors for vascular disease, such as:
-* '''[[Thrombolysis]]''': Administration of clot-dissolving medications.
+* [[Smoking cessation]]
-* '''[[Surgical embolectomy]]''': Surgical removal of the embolus or thrombus.
+* [[Blood pressure]] control
-* '''[[Bypass surgery]]''': Creating a new route for blood flow around the blockage.
+* [[Cholesterol management]]
+* [[Diabetes management]]
-== Prognosis ==
-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.
-== Related Pages ==
+==Related pages==
 * [[Peripheral artery disease]]
 * [[Chronic limb-threatening ischaemia]]
 * [[Vascular surgery]]
+* [[Thrombosis]]
-== Gallery ==
-<gallery>
-File:Arterial_thrombosis_causing_cyanosis.jpg|Arterial thrombosis causing cyanosis
-File:Acuteoccluisionaxartery.png|Acute occlusion of the axillary artery
-File:Angiograph_before_and_after_thrombolytic_therapy_in_a_case_of_thrombosis_on_the_hand.png|Angiograph before and after thrombolytic therapy
-</gallery>
 [[Category:Vascular diseases]]
 [[Category:Medical emergencies]]