Acute limb ischemia : Quick review for residents in interventional radiology

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.