SCAI 2026 Treatment and Management of Complex Peripheral Arterial Disease-Acute Limb Salvage, Dr. Mathews

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Video Summary

The speaker reviews acute limb ischemia (ALI), emphasizing the classic six P’s and warning that paralysis and paresthesia are late, irreversible signs. ALI has a narrow golden window of about six hours before major neuromuscular damage, with significant amputation and mortality risks. Most cases are due to in situ thrombosis, though embolic events are often cardiogenic. Duplex ultrasound is the preferred first imaging test. Treatment includes immediate heparin, supportive care, and endovascular or surgical thrombectomy depending on Rutherford class. Rutherford III limbs are generally nonviable and often require amputation. Reperfusion injury and compartment syndrome are important complications.

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Keywords

acute limb ischemia

six P's

duplex ultrasound

heparin thrombectomy

compartment syndrome