Mark A. Creager, M.D., John A. Kaufman, M.D., and Michael S. Conte, M.D. N Engl J Med 2012; 366:2198-2206June 7, 2012
Stage
A 57-year-old man presents with an acute onset of left foot pain, numbness, and partial loss of motor function. Four months ago, he underwent endovascular treatment for disabling claudication, which included placement of overlapping polytetrafluoroethylene-coated stents in the left superficial femoral and popliteal arteries. His popliteal and pedal pulses are absent, and the foot is cool and mottled. Angiography reveals complete occlusion of the stent, with thrombosis extending distally into the popliteal and tibial arteries below the knee. How should his case be managed?
The Clinical Problem
Acute limb ischemia is defined as a sudden decrease in limb perfusion . . .
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