Acute limb ischaemia

Question 1

Name five signs/symptoms of acute ischaemia?

Answer 1

pain, parasthesia, paralysis, pulseless, pallor, perishingly cold

Question 2

What is the management of acute limb ischaemia?

Answer 2

anticoagulation- IV heparin
Urgent embolectomy/thrombectomy/bypass
Thrombolysis
Amputation if the above fails

Question 3

In a handover for a vascular patient, what is the most crucial information to convey?

Answer 3

?impaired motor and sensory function

Question 4

If both parasthesia and paralysis are present in a limb, around how many hours of ischaemia have occured?

Answer 4

approaching 6 hour window

Question 5

Which classification is used to score severity of acute ischaemia?

Answer 5

rutherford classification I, IIa, IIb, III

Question 6

Name four causes of acute limb ischaemia?

Answer 6

1. thrombo-embolism -> arrhythmia
2. Aneurysm
3. Trauma/iatrogenic
4. Dissection
5. Thrombosis of prev vascular reconstruction
6. In-situ thrombosis of native vessels

Question 7

Which procedure should be performed as a precaution in acute limb ischaemia?

Answer 7

fasciotomy

Question 8

Limb mottling is observed in the foot of a patient. What does this suggest?

Answer 8

non salvageable tissue

Question 9

A patient’s leg is still warm, however you suspect that it is ischaemic/threatened. Why is this?

Answer 9

You can have a threatened limb that still feels quite warm (think of warm mince), however it
will differ from the other limb, therefore always compare.

Question 10

Name two conditions which promote a prothrombotic state

Answer 10

cancer, covid

Question 11

Which is the most common cause of acute ischaemia?

Answer 11

AF