Arterial Embolus and Thrombosis

Shideh Chinichian, MD and Ronald G. Chambers, Jr, MD, FAAFP Reviewed 06/2017
 


BASICS

DESCRIPTION

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

DIAGNOSIS

HISTORY

  • The 5 P’s: If any is present, frequent reevaluations are indicated. Can present acutely in patients without significant collateral circulation. Proximal occlusions lead to more rapid ...

TREATMENT

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

GENERAL MEASURES

Revascularization of an ischemi...

ONGOING CARE

FOLLOWUP 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 American...

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 of...

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...

PEARLS

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

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

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