Acute Limb Ischaemia

• What is acute limb ischaemia?

  Rapid onset of ischaemia in a limb

  Typically due to thrombus blocking arterial supply in distal limb
• What are the RFs of acute limb ischaemia?

  Smoking

  Hypercoagulable state

  Increasing age

  Male

  Alcohol excess

  HTN

  Diabetes

  Poor diet

  Obesity
• What are the signs & symptoms of acute limb ischaemia?

  6 Ps

  • perishingly cold
  • pallor
  • pulselessness
  • painful
  • paraesthesia
  • paralysis
• What are the Inx of acute limb ischaemia?

  Obs

  Full Hx & examination

  ECG

  Bloods (VBG, coag, group & save, FBC, U&Es)

  CT angio (better than USS in this acute disease)
• What is used to classify acute limb ischaemia?

  Rutherford classification

  (usually calculated by vascular team)

  
• What is the management of acute limb ischaemia?

  IV heparin (bolus then infusion)

  Supportive care until surgery

  Surgical thrombectomy

  Amputation (if severe)

  • NOTE: CLTI can become ALI, but this is not the reason for amputation in CLTI (more to do with infection risk)

  Smoking cessation

  Manage BP & diabetes

  Clopidogrel