Acute arterial occlusion
This is due to sudden blockage of the artery stopping the blood supply to the part it supplies. It could arise in multiple situations but two are commonly noted:
- Sudden blockage due to a blood clot from the heart.
- Sudden blockage to the flow of blood following injury to the artery in a road traffic accident, a stab injury or gunshot injury.
When complete blockage takes place then you have only 6 golden hours to save the limb. If revascularization is not done soon then amputation of the involved limb will result.
How will you know there is a blocked artery needing urgent attention?
Remember the 6 ’Ps’ – Pain, Pale, Paresthesia, Paralysis, Pulseless and Perishing with cold.
Pain is so severe that no pain killers are helpful:
- Pale – the limb is white because there is no blood flow.
- Paresthesia – the limb is numb because the nerves are starved due to lack of blood supply.
- Paralysis – there is reduced to no movement because the muscles of the limb have no nutrition which comes through blood.
- Pulseless – The doctor feels no pulses as there is no blood flow.
- Perishing with cold – the limb is ice cold because of the lack of blood supply.
What tests are needed?
Besides the routine blood tests, chest X-Ray, ECG and echocardiogram your doctor will advice:
- Colour Doppler study of the arterial flow in your limb which should tell him about the circulation of the limb.
- CT Angiogram which is more diagnostic telling about the site of blockage and the flow in the distal part of the leg.
Treatment of Acute Arterial Occlusion
This is an emergency and should be sorted out as soon as possible preferably before 6 hours of the blockage or the injury.
- Just as the patient comes he should be given shot of heparin and pain killers.
- An urgent embolectomy is done if the cause is a clot blocking the artery.
- If injury is the cause of the blockage then repair or a bypass is needed to prevent an amputation.