Limb ischemia can be divided into an acute and a chronic form. The diagnosis of acute ischemia must be carried out immediately, immediate revascularization is necessary in most cases. Chronic critical limb ischemia is the most severe form of peripheral arterial occlusive disease (PAOD). It is characterized by rest pain or necrosis or gangrene.
The acute limb ischemia (“acute limb ischemia”, ALI) represents an acutely occurring hypoperfusion of the limb, which is not older than 2 weeks. The causes are usually embolizations or local thromboses on the basis of a pre-existing pathology such as PAOD.
The chronic limb ischemia (“chronic limb ischemia”, CLI) refers to rest pain or ischemic skin lesions such as ulcers or gangrene (Fontaine stage III and IV or Rutherford categories 4–6). It has a high association with cerebrovascular and cardiovascular events. Chronicity is spoken of when symptoms persist for more than 2 weeks.
TASC II Criteria
The consensus document TASC II (Transatlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease) deals with aspects of revascularization in PAOD [1]. According to the TASC criteria, therapeutic treatment options can be derived depending on the local occlusion/stenosis length. The length of the stenosis and its localization regions decide on the therapy: endovascular or open vascular surgery.