Management of acute lower limb arterial occlusion (2026)
Description
Authors: M. Das and N. Nadem-Boueini
Reviewers: T. Bilhim, S. Duvnjak, G. Eldem, F. Wolf, and R. Uberoi
This course corresponds to chapters 2.1.9 Core procedures in interventional radiology, 2.2.1.1.1 Peripheral arterial disease and 2.2.1.1.8 Visceral arterial disease in the European Curriculum and Syllabus for Interventional Radiology.
Abstract
In acute limb ischaemia (ALI), the occlusion typically involves the lower extremity arteries. ALI is characterised by an acute decrease in peripheral perfusion, which may threaten viability and may result in tissue loss with potential amputation if treatment is unsuccessful. The main causes of ALI are arterial embolism and acute thromboembolic events, often occurring in the setting of pre-existing lower limb atherosclerotic disease, with cardiac emboli being another significant contributor. Careful follow up through assessment of the patient is necessary to induce immediate therapy, including percutaneous revascularisation methods, medical therapy, surgery, or a combination of these. Incidence of ALI is about 1.5 patients per 10,000 population a year. The classical clinical symptoms are the six “Ps”: paraesthesia, pain, pallor, pulselessness, poikilothermia, and paralysis. ALI is categorised depending on sensory and motor deficit, whereas category IIa and IIb represent threatened limb, which may be salvageable if promptly treated.
While medical therapy is the first-line treatment, endovascular and surgical treatment are both options, although endovascular techniques offer fast and immediate minimally invasive treatment options with low morbidity and mortality.
Learning objectives
- Learn about causes and pathophysiology of acute arterial occlusion
- Learn the Rutherford classification for acute limb ischaemia
- Learn about different treatment options and how to apply them
- Learn about different interventional treatment devices and how they work
- Learn about potential complications
- Learn about outcome results
Further information
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for Interventional Radiology and corresponds to chapters 2.1.9 Core procedures in interventional radiology, 2.2.1.1.1 Peripheral arterial disease and 2.2.1.1.8 Visceral arterial disease.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one and half hours and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1.5 European CME credits (ECMEC). Please note that this course is taken offline on February 24, 2031.
The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.
The enrolment period of this course is linked to the validity of the All-Access Pass.
Release date: February 2026
