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Emerg Med Clin North Am. 2017 Nov;35(4):889-909. doi: 10.1016/j.emc.2017.07.006. Epub 2017 Aug 23.

Acute Limb Ischemia: An Emergency Medicine Approach.

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Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA; Emergency Department, Beloit Memorial Hospital, 1969 W Hart Road, Beloit, WI 53511, USA. Electronic address:


Acute limb ischemia is a medical emergency with significant morbidity and mortality. Rapid diagnosis is required because it is a time-sensitive condition. Timely treatment is necessary to restore blood flow to the extremity and prevent complications. The differential diagnosis of acute limb ischemia is broad. Classification of severity of acute limb ischemia is based on clinical variables. A suspicion of acute ischemia based on history and physical examination warrants heparin administration and vascular surgery consultation. The decision for endovascular thrombolysis or standard surgery depends on etiology, duration, and location of vascular occlusion. This review evaluates the diagnostic approach and management for acute limb ischemia.


Acute limb ischemia; Arterial thromboembolism; Arterial thrombosis; Compartment syndrome; Peripheral arterial disease; Reperfusion injury

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