Summary Writer: Rose McCarthy
Script Writer: Nedal Katib
Editor: Shannon Thomas
Interviewee: Shannon Thomas
James talks to Shannon Thomas about the approach to the acutely ischaemic limb.
Dr Shannon Thomas is an Australian trained Vascular, Endovascular and Renal Transplant Surgeon who holds appointments at the Prince of Wales Hospital in Sydney, and a conjoint lecturer position at the University of New South Wales. Having completed post fellowship training at the Park Krankenhaus Hospital in Leipzig, Germany and Polyclinico Abano Terme in Veneto, Italy, Shannon has developed a subspecialty interest in Diabetic Vasculopathy, in particular, small vessel angioplasty techniques to salvage critically ischaemic limbs. His other interests include interventional nephrology (Renal Access), Aortic Aneurysmal and occlusive disease, as well as Spinal Access surgery. These interests are accompanied by active vascular research and teaching commitments.
With Dr Shannon Thomas, Vascular/Endovascular & Renal Transplant Surgeon, Prince of Wales Hospital, Sydney, Australia
Acute limb ischaemia is a common vascular emergency that can present in Emergency or on the wards. It is caused by embolism or thrombosis, or rarely by dissection or trauma. Complete acute ischaemia will lead to extensive tissue necrosis within six hours unless the limb is surgically revascularised. Incomplete acute ischaemia can usually be treated medically in the first instance. Patients with irreversible ischaemia require urgent amputation unless it is too extensive or the patient too ill to survive1.
Case 1 – You are a doctor managing the vascular ward on a night shift. You are asked to see a patient with type 2 diabetes who has an infected foot. The patient is already on IV Tazocin. The nurse is concerned as the patient’s left foot looks blue.
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