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Acute limb ischemia may also be caused by traumatic disruption of blood flow to a limb, which may present with either hard signs or soft signs of vascular injury. [15] Hard signs include pulsatile bleeding, expanding hematomas (collections of blood), or absent distal pulses, and must be taken to surgery emergently.
The signs and symptoms of ischemia vary, as they can occur anywhere in the body and depend on the degree to which blood flow is interrupted. [4] For example, clinical manifestations of acute limb ischemia (which can be summarized as the "six P's") include pain, pallor, pulseless, paresthesia, paralysis, and poikilothermia.
Acute compartment syndrome can lead to a loss of the affected limb due to tissue death. [6] [9] Symptoms of acute compartment syndrome (ACS) include severe pain, decreased blood flow, decreased movement, numbness, and a pale limb. [5] It is most often due to physical trauma, like a bone fracture (up to 75% of cases) or a crush injury.
A limb infarction is an area of tissue death of an arm or leg. It may cause skeletal muscle infarction , avascular necrosis of bones, or necrosis of a part of or an entire limb. Signs and symptoms
Critical limb ischemia occurs when the obstruction of blood flow in the artery is compromised to the point where the blood cannot maintain oxygenation of the tissue at rest. [19] This can lead to pain at rest, a feeling of coldness, or numbness in the affected foot and toes. Other complications of severe PAD include lower limb tissue loss ...
The main reason for the acute phase of ischemia-reperfusion injury is oxygen deprivation and, therefore, arrest of generation of ATP (cellular energy currency) by mitochondria oxidative phosphorylation. Tissue damage due to the general energy deficit during ischemia is followed by reperfusion (increase of oxygen level) when the injury is enhanced.
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Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).