الفهرس 
Anatomy of arterial tree in lower limbOnly 14 pages are availabe for public view
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Abstract
Lower limb ischemia has two types acute and chronic, acute lower limb ischemia is caused by sudden obstruction of an artery due to an embolus or thrombosis, chronic lower limb ischemia is a slowly progressing disease process that is usually caused by an obliterating arterial disease. Acute lower limb ischemia must be diagnosed and the patient immediately referred for further management, chronic lower limb ischemia must be diagnosed and its severity (stage) assessed, as the severity of the condition will determine management approach. According to severity chronic ischemia is classified to mild ischemia which is asymptomatic but is suggestive of an increased overall cardiovascular risk, moderate ischemia causes intermittent claudication, critical ischemia manifests itself as pain at rest and many lead to a non-healing chronic leg ulcer and eventually to gangrene, Patients with critical limb ischemia require urgent referral to a vascular surgeon. However normalizing systemic hemodynamic parameters does not guarantee adequate tissue perfusion and in fact some patients still progress to multi-organ dysfunction and death despite meeting ScvO2 targets.
If ischemia is suspected it should be verified with C.T. angiography, color Doppler ultrasonography, Magnetic resonance angiography (MRA) or Ultra-fast computed tomography (C.T.) angiography, invasive arteriography is still the diagnostic standard for establishing the diagnosis and extent of the disease, thus introducing preinterventional guidelines and categories aiming to decide whether a surgical or percutaneous approach would be the treatment of choice. The choice between an endovascular procedure and surgical revascularization is made individually for each patient according to the results of imaging studies, in patients with PAD, PTA is a simple and effective treatment, acute ischemia requires urgent hospitalization. Embolectomy is the first line of treatment in case of an embolus, intra-arterial thrombolysis is an alternative treatment approach, and Angiographic studies using balloons and stents either drug coated or not, may be carried out during the initial phase, provided that the mobility and sensation of the toes and ankle are normal, if the limb is cyanotic or the motor function impaired circulation must be restored immediately with emergency surgery.