5-Minute Emergency Consult
Arterial Occlusion
Arterial Occlusion is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Immediate and severe compromise of the blood supply to a limb, threatening its viability, secondary to the sudden blockage of a peripheral arteryDescription
- 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
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
Immediate and severe compromise of the blood supply to a limb, threatening its viability, secondary to the sudden blockage of a peripheral arteryDescription
- 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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Citation
Schaider, Jeffrey J., et al., editors. "Arterial Occlusion." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307447/all/Arterial_Occlusion.
Arterial Occlusion. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307447/all/Arterial_Occlusion. Accessed October 16, 2021.
Arterial Occlusion. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th edition). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307447/all/Arterial_Occlusion
Arterial Occlusion [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2021 October 16]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307447/all/Arterial_Occlusion.
* Article titles in AMA citation format should be in sentence-case
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ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
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PB - Lippincott Williams & Wilkins
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DB - Emergency Central
DP - Unbound Medicine
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