Abstract
Acute limb ischaemia (ALI) is a serious health complication that threatens limb viability if no adequate therapy is provided. If the patient is not sufficiently treated, an amputation is required in 5% to 30% of cases, and mortality is up to 18%.
Circulatory disorders of the lower extremities are either caused by thrombosis and/or by embolisation in the arterial trunk of the lower limb arteries. Most ALI cases are caused by a peripheral embolisation of the intracardiac thrombus, usually as a result of atrial fibrillation.
Clinical manifestations depend on the location and the extent of the arterial closure. The patient's clinical condition, physical examination and diagnosis through imaging of the affected limb are crucial for further treatment strategy.
At present, we can choose between endovascular techniques, surgical revascularisation or anticoagulant therapy. This article focuses on the possibility of endovascular recanalisation of acute arterial closures using pharmacological or mechanical endovascular systems.
Pharmacological endovascular treatment consists of the application of recombinant tissue plasminogen activator directly into the closure using special perforated thrombolytic catheters. A mechanical endovascular recanalisation system is achieved using the Rotarex system.
This article also presents a group of patients treated with endovascular procedures at the Vascular Centre of the Vítkovice Hospital.