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Emergency Medical Minute


Oct 19, 2020

Contributor: Peter Bakes, MD

Educational Pearls:

  • Classically presents with the 6Ps: Pain, pallor, paresthesia, pulseless, poikilothermia (cold), and paralysis
  • Acute limb ischemia occurs by embolic or thrombotic causes
  • Thrombotic causes are now more common due to aging populations and advancements in vascular surgery like stents which can be a nidus for thrombosis.
  • Sudden onset of pain without prior symptoms is more typical of embolic causes
  • Preceding symptoms leading to acute ischemia are more often from thrombosis
  • Diagnosis can be clinical based on absent pulses, ultrasound or CT angiogram
  • Definitive treatment includes thrombectomy, stenting, or bypass surgery to restore the blood flow to the distal limb


McNally MM, Univers J. Acute Limb Ischemia. Surg Clin North Am. 2018 Oct;98(5):1081-1096. doi: 10.1016/j.suc.2018.05.002. PMID: 30243449.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD