23
Table 35. ALI Medical Therapy
COR LOE
Recommendation
I C-EO In patients with ALI, systemic anticoagulation with heparin
should be administered unless contraindicated.
Table 36. Revascularization for ALI
COR LOE
Recommendations
I C-LD In patients with ALI, the revascularization strateg y should be
determined by local resources and patient factors (e.g., etiolog y
and degree of ischemia).
I A Catheter-based thrombolysis is effective for patients with ALI
and a salvageable limb.
I C-LD Amputation should be performed as the first procedure in
patients with a non-salvageable limb.
I C-LD Patients with ALI should be monitored and treated (e.g.,
fasciotomy) for compartment syndrome aer revascularization.
IIa B-NR In patients with ALI with a salvageable limb, percutaneous
mechanical thrombectomy can be useful as adjunctive therapy to
thrombolysis.
IIa C-LD In patients with ALI due to embolism and with a salvageable
limb, surgical thromboembolectomy can be effective.
IIb C-LD e usefulness of ultrasound-accelerated catheter-based
thrombolysis for patients with ALI with a salvageable limb is
unknown.
Table 37. Diagnostic Evaluation of the Cause of ALI
COR LOE
Recommendations
I C-EO In the patient with ALI, a comprehensive history should
be obtained to determine the cause of thrombosis and/or
embolization.
IIa C-EO In the patient with a history of ALI, testing for a cardiovascular
cause of thromboembolism can be useful.
