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Cardiologist, cardiac surgeon

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

Alexey Kryvenko, medical expert
Last reviewed: 05.07.2025

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Blood flow in peripheral arteries can suddenly stop due to closure of a vessel by a thrombus, embolus, aortic dissection, or acute DIC syndrome.

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Causes of acute peripheral arterial occlusion

Acute peripheral arterial occlusion may result from rupture and thrombosis of an atherosclerotic plaque, embolism originating from the heart, thoracic or abdominal aorta, aortic dissection, or acute DIC.

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Symptoms of acute peripheral arterial occlusion

Symptoms include sudden onset of five symptoms: severe pain, coldness (cold extremity), paresthesia (anesthesia), pallor of the extremity, and pulselessness. Occlusion can be roughly located at the arterial bifurcation distal to where the pulse is still palpable (e.g., at the bifurcation of the common femoral artery, when the femoral pulse is palpable; at the bifurcation of the popliteal artery, when the popliteal pulse is felt). Severe cases may cause loss of motor function. Muscles may be tender to palpation after 6 to 8 hours.

Diagnosis of acute peripheral arterial occlusion

The diagnosis is made clinically. Urgent vasography can confirm the location of the occlusion, identify collateral blood flow, and help guide therapy.

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How to examine?

Dopplerography of the arteries of the lower extremities

X-ray of blood vessels (arteries)

Treatment of acute peripheral arterial occlusion

Treatment consists of embolectomy (catheter or surgical), thrombolysis, or surgical bypass.

Thrombolytic drugs, especially when given locally through a catheter, are most effective in acute arterial occlusions of less than 2 weeks' duration. Tissue plasminogen activator and urokinase are commonly used. A catheter is placed in the area of occlusion, and the thrombolytic agent is given in doses appropriate to the patient's weight and the degree of thrombosis. Treatment is usually continued for 4 to 24 hours, depending on the severity of ischemia and the effectiveness of thrombolysis (relief of symptoms and restoration of pulses or improvement in blood flow demonstrated by Doppler ultrasonography). Approximately 20 to 30% of patients with acute arterial occlusion require amputation within the first 30 days.