Current Options in the Diagnosis and Management of Acute Limb Ischemia

Karthikeshwar Kasirajan, MD, Kenneth Ouriel, MD

Disclosures

Prog Cardiovasc Nurs. 2002;17(1) 

In This Article

Conclusion

Atherosclerosis, the major cause of limb ischemia, is a global phenomenon. As such, attention should be directed not only to the limb at risk but to the patient as whole. Hence, modification of systemic risk factors must play an important role in the long-term care of these patients.

In the acute setting, open operative revascularization, thrombolytic therapy, and PMT should not be viewed as competitive treatment modalities. Rather, a synergistic approach should be offered and the disadvantages of each modality must be recognized and minimized. The "ideal" treatment algorithm may be represented by the initial use of a PMT device with or without initial thrombolytic "lacing," followed by thrombolytic infusion to "clean up" residual thrombus. The culprit lesion should then be addressed by open surgical or endovascular means. Only through the efficient use of the multiplicity of interventional strategies can we hope to diminish the morbidity and mortality of acute peripheral arterial occlusion.

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