A 61 years old lady with limb ischemia due to right femoral artery embolism which was neglected.
Acute limb ischemia (ALI) results from a sudden obstruction in the arterial flow to the extremity due to an embolism or thrombosis. Embolic problems result in a greater degree of ischemia than thrombosis, as the embolus characteristically lodges in a "virgin" vascular bed with no prior collateral development. On the contrary, an in situ thrombosis occurs in vessels with prior, gradual atherosclerotic narrowing that has stimulated the formation of collateral channels. The presence of these collaterals lessens the severity and rapidity of symptom development when the atherosclerotic narrowing progresses to occlusion. It is often difficult to distinguish an embolus from a thrombosis, but embolic occlusions should be suspected in patients with the following features: 1) acute onset, where the patient is often able to accurately time the moment of the event; 2) a history of embolism; 3) a known embolic source, such as cardiac arrhythmias; 4) no prior history of intermittent claudication; and 5) normal pulse and Doppler examination in the unaffected limb. Credit: @dr_aminabtahian
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