REVIEWS  ENDOVASCULAR MANAGEMENT OF VASCULAR EMERGENCIES 

The Journal of Cardiovascular Surgery 2010 June;51(3):329-36

Copyright © 2010 EDIZIONI MINERVA MEDICA

lingua: Inglese

Endovascular management of acute limb ischemia

Peeters P., Verbist J., Keirse K., Deloose K., Bosiers M. ✉

¹ Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium 2 Department of Vascular Surgery, AZ St-Blasius, Dendermonde, Belgium

Acute limb ischemia (ALI) refers to a rapid worsening of limb perfusion resulting in rest pain, ischemic ulcers or gangrene. With an estimated incidence of 140 million/year, ALI is serious limb-threatening and life-threatening medical emergency demanding prompt action. Three prospective, randomized clinical trials provide data on trombolytic therapy versus surgical intervention in patients with acute lower extremity ischemia. Although they did not give us the final answer, satisfactory results are reported for percutaneous thrombolysis compared with surgery. Moreover, they suggest an important advantage of thrombolysis in acute bypass graft occlusions. Therefore, we believe thrombolytic therapy should be a part of the vascular surgeon’s armamentarium to safely and successfully treat ALI patients.