24
Treatment
Figure 3. Diagnosis and Management of ALI
Acutely cold, painful leg
Clinical evaluation including: symptoms, motor and sensory
assessment, arterial and venous Doppler signals
(Class I)
Audible arterial
Audible venous
Inaudible arterial
Audible venous
Inaudible arterial
Inaudible venous
Primary
amputation
(Class I)
Motor function
assessment
Revascularization (emergency) AND
anticoagulation unless contraindicated
(Class I)
Colors correspond to Class of Recommendation on page 26–27.
Suspected ALI
Revascularization (urgent)
AND anticoagulation unless
contraindicated
(Class I)
Category I:
Viable limb
• Normal motor function
• No sensory loss
• Intact capillary refill
Category III: Irreversible
• Complete loss of
motor function
• Complete sensory loss
• Absent capillary refill
Category IIa: Marginally threatened
• Sow-to-intact capillary refill
• Sensory loss limited to toes if
present
• No muscle weakness
Category IIb: Immediately threatened
• Slow-to-absent capillary refill
• Sensory loss more than toes and
with rest pain
• Mild or moderate muscle weakness
Impaired Intact
Salvagable if
treated promptly
Salvagable if
treated emergently
