A systematic review of the management of acute limb ischemia in children
Meyer J, Rother U, Goncalves FB, van de Water W, Schäfer FM, Meyer A, von Klitzing E (2026)
Publication Type: Journal article, Review article
Publication year: 2026
Journal
DOI: 10.1016/j.jvs.2026.02.044
Abstract
Objective: Literature on pediatric acute limb ischemia (PALI) is scarce with controversial management regarding diagnostics and treatment. The aim of this review was to evaluate the management of PALI. Methods: A systematic literature search (PubMed, Embase, Cochrane Library) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed (Prospero registration number CRD420251035570). All English full-text studies published in the past 30 years reporting on acute limb ischemia in children were included. Cases series and cohorts with fewer than 10 patients were excluded from the pooled analysis. Primary outcomes were treatment modalities and diagnostics used. Secondary outcomes were recorded mortality directly linked to PALI and the etiology of PALI, as well as long-term morbidity and amputation rates. Results: In all, 17 studies (2484 children; 66.3% male; mean age, 2.14 years) were included in the quantitative synthesis. In 89.9%, PALI was caused by arterial cannulation. The most commonly affected location was the common femoral artery (49.8%). Ultrasound was the most commonly used diagnostic means. Conservative treatment of PALI was first-line treatment in 87% and was considered successful without the need for surgical intervention (65% of reports; 11/17). Surgery was reserved for failed conservative treatment with an amputation rate of 2.4%. Mortality directly related to PALI was low (0.01%). Conclusions: Acute ischemia in pediatric patients most often occurred iatrogenically. Conservative treatment proved to be successful and should be considered as the treatment of choice.
Authors with CRIS profile
Involved external institutions
DIAKONEO KdöR
Germany (DE)
New University of Lisbon / Universidade Nova de Lisboa
Portugal (PT)
Maastricht University
Netherlands (NL)
Universitätsklinikum Regensburg
Germany (DE)
HELIOS Kliniken
Germany (DE)
Germany (DE)
New University of Lisbon / Universidade Nova de Lisboa
Portugal (PT)
Maastricht University
Netherlands (NL)
Universitätsklinikum Regensburg
Germany (DE)
HELIOS Kliniken
Germany (DE)
How to cite
APA:
Meyer, J., Rother, U., Goncalves, F.B., van de Water, W., Schäfer, F.M., Meyer, A., & von Klitzing, E. (2026). A systematic review of the management of acute limb ischemia in children. Journal of Vascular Surgery. https://doi.org/10.1016/j.jvs.2026.02.044
MLA:
Meyer, Johannes, et al. "A systematic review of the management of acute limb ischemia in children." Journal of Vascular Surgery (2026).
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