Treatment of Aortoiliac Embolism with Profound Limb Paralysis and Sensory Loss in Rutherford Class III Irreversible Acute Limb Ischaemia
Clinical Scenario
Rutherford Class III — IrreversibleThis protocol applies to aortoiliac embolism presenting as acute limb ischaemia classified as Rutherford Class III (irreversible), characterised by profound sensory loss and frank paralysis of the affected limb. This degree of ischaemia signals non-viable tissue and a presentation beyond the window for limb salvage.
Why This Presentation Is Distinct
Rutherford Class III is defined by the combined presence of complete sensory loss and motor paralysis, indicating that the limb has progressed to irreversible ischaemic injury. This distinguishes it from earlier Rutherford classes where revascularisation remains feasible and is the determining factor that shapes the clinical pathway.
Approach (Summary)
When aortoiliac embolism has resulted in irreversible Class III ischaemia, the recommended approach involves a definitive surgical intervention. The complete decision framework — including patient selection, timing, and peri-operative considerations — is detailed in the full structured protocol.
References
DOI: 10.1016/j.ejvs.2019.09.006
Primary amputation is recommended in patients with irreversible (Class III) ischaemia.
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