Acute limb ischaemia (ALI) occurs when there is a sudden lack of blood flow to a limb.[1]
Acute limb ischaemia is caused by embolism or thrombosis, or rarely by dissection or trauma.[2] Thrombosis is usually caused by peripheral vascular disease (atherosclerotic disease that leads to blood vessel blockage), while an embolism is usually of cardiac origin.[3] In the United States, ALI is estimated to occur in 14 out of every 100,000 people per year.[4] With proper surgical care, acute limb ischaemia is a highly treatable condition; however, delayed treatment (beyond 6 to 12 hours) can result in permanent disability, amputation, and/or death.
The New Latin term ischaemia as written, is a British version of the word ischemia, and stems from the Greek terms ischein 'to hold'; and haima 'blood'.[5] In this sense, ischaemia refers to the inhibition of blood flow to/through the limb.
Signs and symptoms Edit
Acute limb ischaemia can occur in patients through all age groups. Patients that smoke and have diabetes mellitus are at a higher risk of developing acute limb ischaemia. Most cases involve people with atherosclerosis problems.[6]
Symptoms of acute limb ischaemia include:
Pain
Pallor
Paresthesias
Poikilothermia
Pulselessness
Paralysis
These symptoms are called "the six P's'";[7] they are commonly mis-attributed to compartment syndrome. One more symptom would be the development of gangrene. Immediate medical attention should be sought with any of the symptoms.[1]
Related conditions Edit
When a limb is ischemic in the non-acute (chronic) setting, the condition is alternatively called peripheral artery disease or critical limb ischemia, rather than ALI. In addition to limb ischemia, other organs can become ischemic, causing:
Renal ischemia (nephric ischemia)
Mesenteric ischemia
Cerebral ischemia
Cardiac ischemia