Treatment of acute limb ischemia with focus on endovascular techniques.
Acute limb ischemia is still the most frequent cause of major limb loss. Timely and fast revascularization is the key for limb salvage and patient survival. Large randomized trials showed equivalency of surgical and endovascular revascularization by means of local lysis with urokinase (TOPAS, STILE). New lytic agents and their modified application such as via a pulse spray catheter or combined with an ultrasound catheter and the combination with glycoprotein IIb/IIIa receptor antagonists have increased the efficacy and speed of thrombolysis. Recently, mechanical thrombectomy devices have become more widespread because intervention time and bleeding complications can be reduced. This review article summarizes the clinical presentation of and the treatment options for acute arterial occlusive disease caused either by embolism or local thrombosis.
Zeller
T
T
Department of Angiology, Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany. thomas.zeller@herzzentrum.de
Tepe
G
G
D000208:Acute Disease; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D004867:Equipment Design; D005121:Extremities / Q000098:blood supply*; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D023821:Limb Salvage; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D016032:Randomized Controlled Trials as Topic; D017131:Thrombectomy / Q000295:instrumentation / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D018084:Ultrasonography, Interventional
D005343:Fibrinolytic Agents; D019039:Platelet Glycoprotein GPIIb-IIIa Complex