ABSTRACT
Acute arterial ischemia affecting the peripheral circulation can be defined as a sudden reduction of the perfusion of an extremity that may produce symptoms ranging from a worsening of preexisting symptoms to a dramatic threat to limb viability. In this chapter, only thromboembolic ischemic events involving the lower extremities are considered. Although cardiac risks are also high, ALI presents a major threat to the limb, necessitating treatment for both limb salvage and prolongation of life. An embolus can be defined as a substance foreign to the usual contents of the vascular tree that travels from its site of origin to a distal site. The most common embolus is thrombotic material arising in the heart. The differential diagnosis includes acute nerve compression that can be distinguished from ALI by the distal presence of pulses, Doppler signals out of keeping with symptoms (including normal ankle brachial index, or ABI), a warm extremity, and location of pain centered on the nerve distribution.
