Background: Acute limb ischemia (ALI) is any sudden decrease in limb perfusion causing a potential threat to limbviability. It is generally accepted that in a patient without underlying arterial disease who develops an acute arterial blockage has approximately six hours for revascularisation before irreversible damage occurs. This study endeavoured to analyse and evaluate the causes and clinical outcome of acute lower limb ischemia. Methods: 154 successive patients visiting INDIRA GANDHI MEDICAL COLLEGE AND HOSPITAL SHIMLA who were diagnosed to haveALI were included in this retrospective study. Thromboembolectomy was performed under regional anaesthesiain 90% of patients, 5% of patients were managed with anticoagulation ACITROM titrated to INR of 2-2.5. Primary amputation was inevitable in 30 patients of class III ischemia. Results: All the ten patients who presented within the golden six hours survived and their limbs could be salvaged without any morbidity. Overall there were 81.52% patients with limb salvaged and 19.48% patients underwent amputation. There was a mortality rate of 3.84% in the study. Conclusions: Overall there was 81.52% limb salvage and 19.48% patients underwent amputation. Revascularization within six hours is ideal (only 9.74% of patients in our study); however, in delayed presentation (90.25%), physiological state of the limb, rather than elapsed time from onset of occlusion will determine the operability. Late revascularization may thus be indicated and is often successful if limb still exhibits signs of viability.
