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Arterial Embolus and Thrombosis

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Acute loss of perfusion distal to occlusion of major arteries due to an embolus (air, fat, amniotic fluid) that migrates to point of occlusion, or a clot/thrombosis (most common) int...

DIAGNOSIS

HISTORY

  • Can present acutely in patients without significant collateral circulation. Proximal occlusions lead to more rapid progression of findings. Occlusion at aortic bifurcation can produce...

TREATMENT

Initial treatment: hemodynamic stabilization (volume resuscitation, maintenance of end-organ perfusion, correction of cardiac arrhythmias) and pain management 

GENERAL MEASURES

Revascularizati...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

After definitive treatment of an embolus, evaluate for other complications of atherosclerosis (carotid stenosis, aortic aneurysm, peripheral vascular disease, and...

REFERENCES

Anderson JL, Halperin JL, Albert NM, et al. Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA guideline recommendations): a report of the America...

ADDITIONAL READING

  • Alonso-Coello P, Bellmunt S, McGorrian C, et al. Antithrombotic therapy in peripheral artery disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College o...

CODES

ICD10

  • I74.9 Embolism and thrombosis of unspecified artery

  • I74.3 Embolism and thrombosis of arteries of the lower extremities

  • I74.5 Embolism and thrombosis of iliac artery

  • I66.9 Occlusion and stenosi...

CLINICAL PEARLS

  • 5 P's of occlusion: pain, pallor, paresthesia, pulselessness, and paralysis

  • Golden period: 4 to 6 hours, after which ischemia leads to irreversible cellular death

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