Arterial Occlusion
Basics
Basics
Basics
Description
Description
Immediate and severe compromise of the blood supply to a limb, threatening its viability, secondary to the sudden blockage of a peripheral artery- Arterial embolization:
- Thrombus or plaque
- Originates from the heart (atrial fibrillation) aneurysms, atherosclerotic lesions or previous graft/stent sites
- Emboli typically lodge where there is an acute narrowing of the artery or branch site
- 75% of emboli involve an axial limb vasculature:
- Femoral 28%
- Arm 20%
- Aortoiliac 18%
- Popliteal 17%
- Visceral and other 9%
- Thrombosis
- Arterial dissection
- Trauma:
- Crush injuries
- Compression
- Arterial contusion and thrombosis
- Arterial transection
- Limb ischemia >6 hr usually results in functional impairment or limb loss:
- If acute on chronic, collateral circulation may preserve tissue beyond 6 hr
- Distal blood flow is entirely dependent on collateral circulation
- Thrombus extends proximally and distally as time goes on due to low flow
Etiology
Etiology
- Embolus:
- Atrial fibrillation
- Myocardial infarction
- Valvular disease
- Endocarditis
- Atrial myxoma
- Aneurysm
- Atherosclerotic plaques
- Paradoxical embolus (venous thromboembolism entering arterial system through communication i.e., PFO)
- Thrombosis:
- Vascular grafts
- Atherosclerosis
- Thrombosis of an aneurysm
- Entrapment syndrome
- Hypercoagulable disorders
- Low flow state
- Heparin-induced thrombosis
- Arterial dissection
- Arterial injury:
- Intimal flap
- Dissection
- Pseudoaneurysms
- Iatrogenic:
- Catheterization
- Arteriography
- Balloon angioplasty
- Complication of arterial puncture
- Penetrating trauma:
- Gunshot, stab wounds, shotgun, shrapnel
- IV drug use
- Blunt trauma
- Joint displacement
- Fracture
- Compartment syndrome
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