An Overlook at the Patients with Acute Lower Limb Ischemia Undergone Femoral Embolectomy
Acute lower limb ischemia is a condition that develops rapidly, and leads to sudden
decrease in limb perfusion, thus threatening the viability of the relevant limb.
This hypoperfusion causes disruption in cardiopulmonary and renal functions
by triggering systemic acid-base and electrolyte imbalance.
Moreover, enabling reperfusion for the treatment of ALLI might cause
mortality by perpetuating electrolyte imbalance and could cause leg edema
leading to compartment syndrome which increases morbidity.
While the risk of amputation is between 10-30% in
patients with ALLI, the mortality rate in the first year is 15-20%.
Pain, pallor, paleness, pulselessness, paresthesia, and paralysis are the main clinical
manifestations of acute arterial ischemia.
An ischemic event threatening an extremity is named
“hyperacute” if it happens earlier than 24 hours, “acute” if it is 1-14 days, “subacute” between
15 days and 3 months, and “chronic ischemia” if it lasts more than 3 months.
The reasons for ALLI are comprised of the acute thrombosis of a native limb artery
or bypass graft, cardiac embolus, dissection, and trauma.
The study 70-80% of the whole embolisms are located in the extremities,
being seen five-fold more frequent in the lower limbs.
Peripheral emboli are located most frequently in the site of femoral bifurcation by 35-40%, and
secondly in the popliteal artery by 14%.5 In other respects, thrombosis often develops
rapidly from an irregular or ulcerated plaque of an atherosclerotic vessel, thus leading to ischemia.
Emerg Med Open J. 2017; 3(2): 58-61. doi: 10.17140/EMOJ-3-143
