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Arterial Embolism/Thrombosis

Mai C. Vang, MD and Ronald G. Chambers, Jr., MD, FAAFP Reviewed 06/2019
 


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 thrombus (most common) intrinsic t...

DIAGNOSIS

HISTORY AND PHYSICAL EXAM

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

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 treatment, evaluate for other complications of atherosclerosis (carotid stenosis, aortic aneurysm, peripheral vascular disease, and coronary arterial diseas...

REFERENCES

1
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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