[Differential indications for surgical and conservative internal medicine procedures in the treatment of acute ischemia of the leg].

Re-opening of the main arterial pathway is the most efficient method for treatment of arterial occlusive disease in stage III and IV. In addition to surgical thromb-embolectomy catheter procedures such as percutaneous transluminal angioplasty, catheter lysis and catheter extraction of fresh clots may give satisfactory results. The following methods are indicated in acute cases: catheter procedures for occlusions of the popliteal trifurcation and profound femoral artery, segmental occlusions of the superficial femoral artery, femoro-popliteal occlusions with impaired run-off, recurrent occlusions after desobliteration with both surgical methods, occlusions of lower arm arteries; surgical thrombectomy for occlusions of the aortic bifurcation, the iliac arteries, the femoral bifurcation, for femoro-popliteal aneurysms and for occlusions of the subclavian and axillary artery. Both procedures do not exclude each other and may be combined according to the relevant indications.