Acute limb ischemia
Etiology
Acute embolic ischemia
Acute thrombotic ischemia
Arterial trauma
Acute compartment syndrome
Traumatic
Acute external compression
Thrombotic
Acute aortic dissection
Embolic
Phlegmasia
Sources
Site of impaction
Def.
Clinical features
Clinical consequences
DD
Pathological consequences
TTT
Investigations
Non-cardiac
Cardiac 80-90%
Endocarditis
Myocardial infarction
AF
commonest
Less common causes
Femoral bifurcation 40%
Popliteal bifurcation
Brachial bifurcation
Aortic bifurcation
Common carotid bifurcation
2ry venous thrombosis
Compartment syndrome
2ry arterial thrombosis
Systemic & metabolic sequels
Volkmann's ischemic contracture
Ch. ischemia
Gangrene
Complete recovery
6 Ps
3 signs
3 symptomes
NBs
Imaging
Lab.
Duplex
Echo
Arteriography
Raised Hb, BUN & creatinine
Acidosis , raied CK & WBCs
Acute thrombotic ischemia
Embolectomy
General (H&H)
9
1ry amputation
( if irreversible ischemia )
Acute thrombotic ischemia conditions
TTT
Virchow's triad
Viscosity
Velocity
Vessel wall
On top of ch. occlusive arterial dis.
As a complication of arterial aneurysm
As a complications of febrile illness
If no immediate threat
Salvageable threatened limb
(Rutherford ll A)
Angiography then
CDT or PMT or both
DT thechnique
Complications
Thrombolytic agents
Immediately threatened limb
(Rutherford llB)
Potentially unsalvageable
(Rutherford lll)
CP
Investigations
Pathological types
TTT
etiology
Blunt
Iatrogenic
Penetrating
Intaarterial drug injection
Immediate presentation
Delayed consequences
Intimal flap
Arterial division
Arterial spasm
Arterial contusion
(commonest)
Partial
Complete
Pseudoaneurysm
Arteriovenous fistula
Soft signs
Hard signs
No arterial injury signs
X-ray
ABI
Lab.
Vascular imaging
Stabilize the pt.
Definitive ttt
Control of bleeding
Complications managment