Acute limb ischemia (ALI) can be a devastating clinical emergency with potentially limb- or life-threatening consequences. It is defined as a quickly developing or sudden decrease in limb perfusion producing new or worsening symptoms and signs, often threatening limb viability. ALI is commonly related to an acute arterial occlusion. Rarely, extensive venous occlusion can lead to upper and lower extremities ischemia (ie, phlegmasia). The incidence of acute peripheral arterial occlusion causing ALI is approximately 1.5 cases per 10,000 people per year. The clinical presentation depends on the etiology and whether the patient has underlying peripheral artery disease. Except for traumas, the most common etiologies are embolic or thrombotic events. Peripheral embolism, likely related to embolic heart disease, is the most common cause of acute upper extremity ischemia. However, an acute thrombotic event may occur in native arteries, at the site of a pre-existing atherosclerotic plaque, or as a failure of previous vascular interventions. The presence of an aneurysm may predispose to ALI for both embolic and thrombotic mechanisms. Immediate diagnosis, accurate assessment of limb viability, and prompt intervention, when needed, play important roles in salvaging the affected limb and preventing major amputation. Severity of symptoms is usually dependent on the amount of surrounding arterial collateralization, which may often reflect a pre-existing chronic vascular disease. For this reason, early recognition of the underlying etiology is crucial for choice of best management and definitely for treatment success. Any error in the initial evaluation may negatively affect the functional prognosis of the limb and endanger the patient's life. The aim of this article was to discuss diagnosis, etiology, pathophysiology, and treatment of patients with acute ischemia of the upper and lower limbs.

急性肢体缺血(ALI) 可能是一种毁灭性的临床紧急情况，可能会危及肢体或生命。它被定义为肢体灌注快速发展或突然减少，产生新的或恶化的症状和体征，通常威胁肢体的生存能力。ALI 通常与急性动脉闭塞有关。极少数情况下，广泛的静脉闭塞会导致上肢和下肢缺血（即痰液）。急性外周动脉闭塞引起的 ALI 发病率约为每年每 10,000 人 1.5 例。临床表现取决于病因以及患者是否患有潜在的外周动脉疾病。除创伤外，最常见的病因是栓塞或血栓事件。外周栓塞可能与栓塞性心脏病有关，是急性上肢缺血的最常见原因。然而，急性血栓事件可能发生在天然动脉中、先前存在的动脉粥样硬化斑块的部位，或者由于先前的血管干预措施的失败而发生。动脉瘤的存在可能因栓塞和血栓形成机制而诱发急性肺损伤。立即诊断，准确评估肢体活力，及时必要时进行干预对于挽救受影响的肢体和防止大截肢具有重要作用。症状的严重程度通常取决于周围动脉侧支循环的数量，这通常可能反映了先前存在的慢性血管疾病。因此，早期识别潜在病因对于选择最佳治疗方法以及治疗成功至关重要。初始评估中的任何错误都可能对肢体的功能预后产生负面影响并危及患者的生命。本文的目的是讨论上肢和下肢急性缺血患者的诊断、病因、病理生理学和治疗。

急性肢体缺血(ALI) 可能是一种毁灭性的临床紧急情况，可能会危及肢体或生命。它被定义为肢体灌注快速发展或突然减少，产生新的或恶化的症状和体征，通常威胁肢体的生存能力。ALI 通常与急性动脉闭塞有关。极少数情况下，广泛的静脉闭塞会导致上肢和下肢缺血（即痰液）。急性外周动脉闭塞引起的 ALI 发病率约为每年每 10,000 人 1.5 例。临床表现取决于病因以及患者是否患有潜在的外周动脉疾病。除创伤外，最常见的病因是栓塞或血栓事件。外周栓塞可能与栓塞性心脏病有关，是急性上肢缺血的最常见原因。然而，急性血栓事件可能发生在天然动脉中、先前存在的动脉粥样硬化斑块的部位，或者由于先前的血管干预措施的失败而发生。动脉瘤的存在可能因栓塞和血栓形成机制而诱发急性肺损伤。立即诊断，准确评估肢体活力，及时必要时进行干预对于挽救受影响的肢体和防止大截肢具有重要作用。症状的严重程度通常取决于周围动脉侧支循环的数量，这通常可能反映了先前存在的慢性血管疾病。因此，早期识别潜在病因对于选择最佳治疗方法以及治疗成功至关重要。初始评估中的任何错误都可能对肢体的功能预后产生负面影响并危及患者的生命。本文的目的是讨论上肢和下肢急性缺血患者的诊断、病因、病理生理学和治疗。