[Acute limb ischemia : Quick review for residents in interventional radiology]
Matthäus Reinert1, Patrick Kupczyk2
1Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland. matthaeus.reinert@ukbonn.de.
Background:
Knowledge of diagnosis and treatment of acute limb ischemia is essential to preserve limb viability and prevent irreversible damage.
Objective:
A brief review of treatment options, patient selection, and management in acute limb ischemia is provided for residents in interventional radiology.
Methods:
The most commonly used interventional treatment options in acute limb ischemia including case studies and recommendations are provided.
Results:
In acute limb ischemia, the decision between therapeutic procedures (interventional or surgical) depends on the clinical stage. There are three main interventional procedures: catheter-directed thrombolysis, thromboaspiration, and mechanical thrombectomy using specialized catheters; a combination of these procedures is also possible. The decision depends on various factors, some of which are center-specific, and should therefore always be made by interdisciplinary consensus. After near-complete revascularization, the cause should be sought and eliminated.
Conclusions:
In a case of suspected acute limb ischemia, patients should ideally be taken to an interdisciplinary center with interventional radiology and vascular surgery. After clinical evaluation and noninvasive imaging, a decision regarding possible therapeutic options can be made.
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