Acute Ischemia due to Superficial Femoral Artery Thrombosis: Results of In Situ Fibrinolysis.

L’infirmière face à une ischémie aiguë du membre inférieur

Embolies artérielles des membres

Gestione in urgenza di un paziente con ischemia acuta degli arti inferiori

L’ischemie des membres inferieurs est une urgence medico-chirurgicale. Les signes cliniques d’ischemie aigue associent pâleur cutanee, absence de pouls, diminution de la temperature du membre et douleurs. L’apparition de signes neurologiques peripheriques est un critere de gravite. Le pronostic depend de la circulation collaterale preexistante, de la nature de l’occlusion (embol versus thrombose), de la duree de l’ischemie, de la topographie des lesions (gravite des occlusions proximales telles que les occlusions aortiques aigues) et des comorbidites associees. En cas d’occlusion aigue de membre inferieur, l’avis d’un chirurgien vasculaire est demande en urgence. Le patient est montre a l’anesthesiste des l’indication operatoire posee. Le bilan pre-operatoire doit, dans un premier temps, se restreindre a l’indispensable : bilan biologique et, selon les disponibilites, realisation d’un echo-doppler des vaisseaux. L’opportunite d’une arteriographie est discutee car rien ne doit retarder la desobstruction arterielle, notamment en cas d’etiologie embolique. En l’absence de contre-indication, le premier traitement a mettre en route est une heparinotherapie. Le traitement chirurgical de revascularisation (embolectomie par sonde de Fogarty ou pontage) peut etre associe a des techniques complementaires de lavage de membre ou d’aponevrotomie de decharge dans le cas de syndrome des loges.

https://capcuuamateur.files.wordpress.com/2013/10/ischemie-membre-inferieure.pdf

Prise en charge en urgence d'un patient en ischémie aiguë des membres inférieurs

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Gestione in urgenza di un paziente con ischemia acuta degli arti inferiori

Prise en charge en urgence d'un patient en ischémie aiguë des membres inférieurs