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Acute occlusion of peripheral arteries: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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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.
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.