Acute limb ischemia Quiz: Ace Your Exams
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A 63-year-old woman presents to the emergency department with severe right leg pain. The patient normally has pain after ambulating about 100 meters, but this morning she began having pain at rest. She tried to avoid coming to the hospital, but after seven hours, the pain never went away. Her last ankle brachial index was 0.8 on the left and 0.5 on the right. Past medical history is significant for bilateral lower extremity peripheral arterial disease and diabetes-associated peripheral neuropathy. Temperature is 36.8ºC (98.2ºF), pulse is 78/min, respiratory rate is 18/min, and blood pressure is 141/92 mmHg. On physical exam, the right leg is cool and pale without palpable pulses or doppler signals. She cannot move the right foot, and there is numbness up to the mid-calf. CT angiography is ordered and pending. Which of the following is the most appropriate treatment and subsequent study for this patient?
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