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Cardiologist, heart surgeon

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Acute occlusion of peripheral arteries: causes, symptoms, diagnosis, treatment

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Blood flow in the peripheral arteries can be severely disrupted due to closure of the vessel with a thrombus, embolus, with aortic dissection or acute DIC syndrome.

trusted-source [1], [2], [3]

Causes of acute occlusion of peripheral arteries

Acute occlusion of peripheral arteries can be the result of rupture and thrombosis of atherosclerotic plaque, embolism originating from the heart, thoracic or abdominal aorta, aortic dissection or acute DIC syndrome.

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Symptoms of acute occlusion of peripheral arteries

Symptoms include the sudden appearance of five symptoms: severe pain, a feeling of cold (cold extremity), paresthesia (anesthesia), pale extremities and lack of pulse. Occlusion can be approximately detected in the area of arterial bifurcation distal to the place where the pulse is still palpable (for example, at the point of bifurcation of the common femoral artery, when the femoral pulse is palpable, in the popliteal artery bifurcation when the popliteal pulse is determined). Severe cases can cause loss of motor function. After 6-8 hours, the muscles can be soft on palpation.

Diagnosis of acute occlusion of peripheral arteries

The diagnosis is established clinically. Urgent vasography can confirm the location of occlusion, identify collateral blood flow and help in choosing a therapy.

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How to examine?

Doppler ultrasonography of the arteries of the lower extremities

Roentgen of vessels (arteries)

Treatment of acute occlusion of peripheral arteries

Treatment consists of embobectomy (catheter or surgical), thrombolysis or surgical shunting.

Thrombolytic drugs, especially when administered locally through a catheter, are most effective in acute arterial occlusions with a duration of less than 2 weeks. Typically, a tissue plasminogen activator and urokinase are used. The catheter is led to the occlusion area, and the thrombolytic agent is administered in doses corresponding to the body weight of the patient and the degree of thrombosis. Treatment is usually continued for 4-24 hours, depending on the severity of ischemia and the effectiveness of thrombolysis (reducing symptoms and restoring the pulse or improving blood flow, as confirmed by Doppler ultrasound). Approximately 20-30% of patients with acute arterial occlusion need amputation within the first 30 days.