The diagnosis and treatment of acute limb ischemia (ALI) has long been a fierce adversary that has evolved over the last several decades with scientific advancements in endovascular therapy.

History and physical examination remain the mainstay of diagnosis enhanced by detailed imaging to guide therapy. Many endovascular tools are available for prompt restoration of flow that compliment traditional surgical options. These devices incorporate the mechanical removal of thrombus and the chemical dissolution of thrombus . Medical decision-making for ALI patients must take into account the patient characteristics, anatomic variables, mechanism of ischemia, degree of ischemia, and operator skill to employ the right strategy for the right patient. This moving target challenges scientific study, making the therapeutic bedside decision making an artform. We present an overview of the field, supportive data, and a treatment algorithm that hopefully captures this delicate balance.

长期以来，急性肢体缺血 (ALI) 的诊断和治疗一直是一个激烈的对手，在过去的几十年里，随着血管内治疗的科学进步，它不断发展。

病史和体格检查仍然是通过详细的影像学指导治疗而得以增强的诊断的主要手段。许多血管内工具可用于迅速恢复血流，这些工具与传统手术选择相得益彰。这些装置结合了血栓的机械去除和血栓的化学溶解。ALI 患者的医疗决策必须考虑患者特征、解剖变量、缺血机制、缺血程度和操作者技能，以便为正确的患者采用正确的策略。这个移动的目标挑战了科学研究，使治疗床边的决策成为一种艺术形式。我们提供了该领域的概述、支持性数据和治疗算法，希望能够捕捉到这种微妙的平衡。