Epidemiological and Therapeutic Aspects of Acute Non-Traumatic Lower Limb Ischemia: A Retrospective Analysis of 50 Cases

Acute non-traumatic ischemia of the lower limbs (ANLLI) remains a critical vascular emergency with a high risk of amputation and mortality if not diagnosed and treated promptly. The objective of this study was to analyze the epidemiological, clinical, and therapeutic aspects of ANLLI and to assess the outcomes of surgical and endovascular management in our institution. We conducted a retrospective analysis of 50 patients admitted for ANLLI at the Military Hospital of Marrakech between January 2018 and February 2022. Demographic characteristics, risk factors, clinical presentations, management strategies, and postoperative outcomes were collected and analyzed. The average age was 52 years (range 25–94), with a predominance of females (80%). Diabetes (78%), hypertension (40%), and smoking (30%) were the most common cardiovascular risk factors. Pain was the initial symptom in all cases, while pallor (84%), coldness (80%), paresthesia (30%), and paralysis (14%) were also observed. The left limb was more frequently affected (52%). All patients received initial anticoagulation, followed by surgical or endovascular intervention: embolectomy (60%), thrombectomy (20%), bypass (12%), and thrombolysis (8%). Postoperative complications occurred in 26% of cases, with an amputation rate of 10% and mortality rate of 1%. These results underline the necessity of early diagnosis, prompt revascularization, and rigorous postoperative monitoring to improve limb salvage and survival outcomes.