n CME : Your SA Journal of CPD - Acute lower extremity ischaemia




Acute lower extremity ischaemia (ALEXI) is often defined as a sudden loss of perfusion to the lower extremity/extremities of less than 14 days' duration, resulting in variable ischaemic clinical manifestations and the potential risk of limb loss. The incidence is ~1.5 cases per 10 000 persons per year. Acute ischaemia threatens limb viability because there is insufficient time for new blood vessel growth to compensate for loss of perfusion. Diagnostic errors and treatment delays are unforgiving, and may result in loss of limb or life. In-hospital amputation rates may range from 10% to 40% in Western series. Rapid referral to a dedicated vascular service for assessment and expeditious treatment is mandatory. A matter of a few hours can mean the difference between a major amputation, limb salvage or death. Approximately 15 - 20% of patients die within the first year after ALEXI, with most of these deaths occurring in the peri-operative period.


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