Podcast 605: Acute Limb Ischemia

<p><strong>Contributor: Peter Bakes, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Classically presents with the 6Ps: Pain, pallor, paresthesia, pulseless, poikilothermia (cold), and paralysis</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Acute limb ischemia occurs by embolic or thrombotic causes</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Thrombotic causes are now more common due to aging populations and advancements in vascular surgery like stents which can be a nidus for thrombosis.</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Sudden onset of pain without prior symptoms is more typical of embolic causes</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Preceding symptoms leading to acute ischemia are more often from thrombosis</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Diagnosis can be clinical based on absent pulses, ultrasound or CT angiogram</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Definitive treatment includes thrombectomy, stenting, or bypass surgery to restore the blood flow to the distal limb</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">McNally MM, Univers J.</span> <a href="https://pubmed.ncbi.nlm.nih.gov/30243449/"><span style= "font-weight: 400;">Acute Limb Ischemia</span></a><span style= "font-weight: 400;">. Surg Clin North Am. 2018 Oct;98(5):1081-1096. doi: 10.1016/j.suc.2018.05.002. PMID: 30243449.</span></p> <p><em><span style="font-weight: 400;">Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD</span></em></p> <p><br /> <br /></p>