Acute ischemia of the extremities

Acute ischemia of the extremities is the most frequent vascular surgical emergency and requires acute or subacute treatment to ensure limb salvage, depending on the severity. This article provides an overview on the definition, pathophysiology and treatment situation as well as on the multitude of options for open surgical and endovascular forms of treatment. The number of patients with previous surgery and therefore more complex vascular pathologies is steadily increasing. Hence, the importance of modern endovascular procedures (e.g., catheter-directed thrombolysis and percutaneous thrombectomy) as well as improvement of inflow and outflow with balloon angioplasty or stents within hybrid interventions is increasing. A final assessment of the procedure from a scientific perspective is often not possible based on the current data situation but is absolutely necessary. Until then, the decision on the most suitable form of treatment is based on experience and the technical options available to the treating physician.