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Arterial Occlusion

Arterial Occlusion is a topic covered in the 5-Minute Emergency Consult.

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Emergency Central

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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 artery
  • Arterial embolization
    • Thrombus or plaque
    • Originates from aneurysms or atherosclerotic lesions
    • Emboli typically lodge where there is an acute narrowing of the artery
    • 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.

Etiology

  • Embolus:
    • Atrial fibrillation
    • Myocardial infarction
    • Valvular disease
    • Endocarditis
    • Atrial myxoma
    • Aneurysm
    • Atherosclerotic plaques
    • Paradoxical embolus
      • Patent foramen ovale
  • Thrombosis
    • Vascular grafts
    • Atherosclerosis
    • Thrombosis of an aneurysm
    • Entrapment syndrome
    • Blood clotting 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

Rosen, Peter, 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: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307447/all/Arterial_Occlusion. Accessed April 26, 2019.
Arterial Occlusion. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307447/all/Arterial_Occlusion
Arterial Occlusion [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. 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
TY - ELEC T1 - Arterial Occlusion ID - 307447 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307447/all/Arterial_Occlusion PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -