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Acute Limb Ischemia (Onset Classification (Acute (Ischemia <14 days),…
Acute Limb Ischemia
Onset Classification
Acute
Ischemia <14 days
Acute on chronic
Worsening symptoms and signs (14 days)
Chronic
Ischemia stable >14 days
Subacute
Unstable ischemia 14 days-3 months
Etiology
Acute arterial embolism
Relatively healthy
arterial tree
Source
Cardiac
AF
LV thrombus
Shunt
Aorta
Mural thrombus
Acute arterial thrombosis
PREVIOUSLY DISEASED
arterial tree
Differences between embolus and thrombosis
Severity
Embolus: Complete, no collateral
Thrombosis: Incomplete, collaterals+
Onset
Embolus: Seconds/minute
Thrombosis: Hours or day
Limb affected
Embolus: Leg 3:1 arm
Thrombosis Leg 10: 1 arm
Multiple sites
Embolus: Up to 15%
Thrombosis: Rare
Embolus source
Embolus: Present
Thrombosis: absent
Previous claudication
Embolus: absent
Thrombosis: Present
Palpation of artery
Embolus: Soft, Tender
Thrombosis: hard, calcified
Definition
Sudden decrease of arterial limb perfusion
Cause: Threat to limb viability