Acute Limb Ischemia

Discussion on acute limb ischemia. Classical clinical presentation of acute limb ischemia has been described as Six Ps of critical limb ischemia: Pale, Painful, Pulseless, Paralyzed, Paraesthetic, Perishing cold (or poikilothermia – impaired regulation of body temperature). The limb usually becomes cool, in accordance with room temperature, which is usually colder than body temperature. Some call the first 5 ones as 5 Ps of critical limb ischemia. Pallor is due to lack of blood supply. Pain is due to limb ischemia. Pulses are absent as expected, due to the vascular occlusion. Paralysis is due to ischemia of motor nerves and muscles. Paraesthesia is due to involvement of the sensory nerves. Critical limb ischemia has dual importance of being more severe disease process and association with cardiovascular disease risk.