Computed tomography angiography evaluation of acute limb ischemia

Alex Wallace, Yash Pershad, Aman Saini, Sadeer Alzubaidi, Sailendra Naidu, Grace Knuttinen, Rahmi Oklu

Research output: Contribution to journalArticle

Abstract

Acute limb ischemia (ALI), a subclass of critical limb ischemia, is a medical emergency. The cause of ALI is usually thrombotic or embolic in nature, and the specific etiology often dictates the appropriate therapy. While the diagnosis is a clinical with common presenting symptoms, advances in ultrasound, computed tomography, and magnetic resonance technology have impacted the diagnosis and subsequent therapy. In ALI, the time to revascularization is critical and computed tomography angiography (CTA) provides a highly sensitive and specific technique for rapidly identifying occlusions and precisely defining vascular anatomy prior to interventions. In patients with significant renal disease, magnetic resonance angiography with or without contrast provides effective alternatives at the expense of imaging time. Treatment can include a variety of endovascular or surgical interventions, including thromboembolectomy, angioplasty, or bypass. Proper evaluation of the etiology of the ischemia, affected vasculature, and medical history is critical to select appropriate treatment and improve patient outcomes. Here, we examine the presentation, evaluation, and treatment of ALI and the role of CTA in diagnosis and therapy.

Original languageEnglish (US)
Pages (from-to)57-64
Number of pages8
JournalVASA. Zeitschrift fur Gefasskrankheiten
Volume48
Issue number1
DOIs
StatePublished - Jan 1 2019

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Keywords

  • Acute limb ischemia
  • CTA
  • Endovascular
  • Peripheral artery disease
  • Thromboembolic disease
  • Thromboembolism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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