Emergency Cases Northwest Group

Case 053 Collateral Chicanery

Situation

Ischaemic limb regained colour: but the artery was still occluded; it was collateral circulation that restored the colour.

Background

An elderly man presented with a pale, cold painful arm with no pulse. Even before any treatment the colour improved though the was still no pulse.

Assessment

The brachial artery was still occluded, likely from an emboli caused by AF. The colour returned because some blood reached the distal arm vis smaller collateral vessels.

He went on to have a embolectomy via local anaesthetic under the Vascular Surgeons.

Recommendation

In the acute ischaemic limb presentation don't relax if the colour returns, if there is no pulse an operation may still be necessary.



PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED IMAGES

Emergency Cases Northwest Group