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Acute limb ischemia is the condition in which there is a sudden decrease in limb perfusion causing a threat to the viability of the limbs, especially at the extremities. Partial or complete occlusion of the arterial supply to the limbs can lead to rapid ischemia and poor function of the limb within a matter of hours.
CARE Hospitals offer all-encompassing diagnostic and treatment services using state-of-the-art infrastructure equipped with the latest technology to perform minimally invasive procedures on patients with a wide spectrum of diseases and medical needs. Our multidisciplinary team of doctors and care providers offer end-to-end care to every patient keeping their needs in mind for the overall improvement of the health and safety of the patients. It goes without saying, you will be taken care of while seeking Acute Limb Ischemia Treatment in Hyderabad at CARE Hospitals.
Acute limb ischemia can be divided into three broad categories depending on their causes:
This is the most common reason for limb ischemia where a thrombus from a proximal source travels distally to occlude an artery causing blockage to the flow of blood. The original thrombus source may be post-MI mural-thrombus, abdominal aortic aneurysm, or prosthetic heart valves.
Thrombosis in situ
In this type of condition, the atheroma plaque in the artery ruptures and a thrombus forms on the spot.
This is a less common cause of acute limb ischemia and may include compartment syndrome as a cause.
Other common causes of acute limb ischemia include left ventricular wall thrombosis following myocardial infarction (heart attack), cardiac/aortic tumor, and atrial fibrillation.
The signs and symptoms of acute limb ischemia are described using the six Ps:
This condition is often characterized by a sudden onset of these symptoms. Late admission to the hospital for the acute limb ischemia treatment can result in irreversible damage to the neuromuscular structures leading to paralysis of the affected limb. Other symptoms of acute limb ischemia can be attributed to the following:
Chronic limb ischemia,
Abdominal or back pain,
Our cardiovascular specialists and cardiologists take immense care to provide proper diagnosis of the patients based on the physical health of the patient and the severity or progress of limb ischemia. Diagnosis may be done based on medical history, visual examination, and other diagnostic tests.
Doppler ultrasound scan
Doppler ultrasound using vascular ultrasonography of the peripheral arterial pulse may be performed followed by a contrast CT angiography.
Computed Tomography (CT) angiography
CT angiography using contrast dye can be performed to examine the whole body for locating embolisms in the whole body as well as to determine the range of the occluded site and locate the source of the embolus.
Other tests can be done to identify the cause and evaluate the overall general health of the patient using electrocardiography, thoracoabdominal radiography, urine and blood analysis, and echocardiography.
Acute limb ischemia is a surgical emergency. The main goal of acute limb ischemia treatment in Hyderabad may be to preserve the affected limb. Complete arterial occlusion may lead to irreversible tissue damage. Our team of board-certified cardiovascular surgeons work together with cardiologists and other healthcare specialists to deliver the best results as quickly as possible without further damage. Heparin therapy may be administered, however, in advanced cases, surgical intervention may be required.
If the cause of limb ischemia is embolic, the surgical options available are:
Local intraarterial thrombolysis
If the cause of limb ischemia is a thrombotic disease, the surgical options available are:
Angioplasty using a stent
Local intraarterial thrombolysis
If limb ischemia advances to an irreversible stage, limb amputation may be required.
The most important complication of acute limb ischemia is reperfusion injury in which there is a sudden increase in capillary permeability. This may result in:
• Compartment syndrome,
• release of substances from the damaged muscle cells, such as- K+ ions causing hyperkalemia, H+ ions causing acidosis, Myoglobin resulting in significant AKI.
Acute limb ischemia has a mortality rate of around 20%, therefore, it is necessary to monitor for reperfusion syndrome and may require haemofiltration.
Reduction of cardiovascular mortality risk is the most important thing to keep in mind for patients with acute limb ischemia. Regular exercise, quitting smoking, and sometimes weight loss may be necessary. Any underlying predisposing condition that may lead to acute limb ischemia in the future should be treated.
Patients undergoing amputation require occupational physiotherapy which may be guided by our experienced physiotherapists. A long term rehabilitation plan may also be required for such patients to cope with post-surgical activities as well as how they may be feeling.
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