3. Thrombotic Limb Ischemia

Question 1

What is thrombotic limb ischemia?

Answer 1

solid mass formed by circulating constituents of blood stream, obstructing a partially occluded artery

Question 2

What is the pathogenesis of thrombotic limb ischemia?

Answer 2

Virchow’s Triad
1. Vessel Wall
2. Velocity
3. Viscosity

Question 3

What are the etiologies of thrombotic limb ischemia?

Answer 3

• Atheroslerotic segment!!!
• Arteritis
• Thrombosed aneurysm
• Durg abuse

Question 4

What are the clinical manifestations of thrombotic limb ischemia?

Answer 4

6Ps + signs & symptoms of acute ischemia

Question 5

What are the clinical findings of thrombotic limb ischemia?

Answer 5

• Old age
• Hx of claudication pain
• No source of emboli
• Less sever than embolic (collaterals)
• Atherosclerotic vessel wall
• Presence of manifestations of chronic ischemia (ischemic ulcers)
  *sudden worsening of intermittent claudication pain in non-cardiac pt.
  *claudication > rest pain

Question 6

What are the investigations for thrombotic limb ischemia?

Answer 6

Arteriography
- confirm diagnosis
- define site of lesion
- study distal arterial tree
- define plan for arterial occlusion

*check for light touch

Question 7

What are the signs for a thrombotic origin?

Answer 7

• Irregular artery wall
• Stenotic segment
• Extensive collaterals
• Distal run-off

Question 8

What are the treatments for thrombotic limb ischemia?

Answer 8

1. Fibrinolytic therapy
2. Arterial reconstructive procedure