What are the treatment options for acute limb ischemia?
Medicines: Thrombolytic agent (Blood clot-dissolving medicines).The preferred treatment for mild to moderate, severe cases.
Embolectomy: Physical removal of a blood clot.
This can be achieved by:
a) Surgical embolectomy
b) Non-surgical embolectomy
Hybrid approach: Involving medical therapy with thrombolytic medicines that soften the blood clot followed by non-surgical removal of the thrombus is a modern approach. In this procedure, a plastic tube (catheter) is inserted into the blood clot and dripped with the medicine over 12 to 24 hours. This will soften the clots making it amenable for removal by extraction catheter.
What are the various surgical procedures for treating acute limb ischemia?
Opening of the occluded artery and pulling off the blood clot.
Removal of the blood clot by fragmenting it using suction or laser or ultrasound energy.
Time tested strategy
severe limb ischemia
Large-sized blood vessels
Clots in the proximal to medium blood vessels
Severe acute limb ischemia involving large blood vessels best managed
High success rate
Moderate to less severe limb ischemia
medium-sized to small-sized blood vessels
Clots in the medium to distal blood vessels
A hybrid approach is possible
minimally invasive procedure
Short hospital stay
No risk of infection
Less risk of cardiac complications
Not useful for small arteries
Cannot be combined with medical therapy using a thrombolytic agent
Prolonged hospital stay
Risk of infection
Increased risk of cardiac events: Heart failure, Heart attack & consequent death
A hybrid approach is not possible
Not useful for large arteries
Cannot be used for severe ischemia involving large arteries and late cases
What is the uniqueness of treatment for acute limb ischemia by Dr C Raghu?
Acute limb ischemia is managed by using a hybrid strategy at Dr Raghu’s Cath lab. Combing an approach of catheter-directed thrombolysis followed by non-surgical embolectomy using the penumbra technology is a routine procedure at our centre. Being one of the early adopters of penumbra technology, we are well versed in the nuances and experts in delivering results. Dr Raghu has delivered many lectures at various national and international fora and has been training many doctors to adapt to this new technology.