Arterial occlusion is defined as a condition of acute lack of tissue perfusion due to sudden cessation of circulation. Main axial artery of the limb is blocked presenting within minutes to hour after occlusion.

1. en love da Homoeopathy
ARTERIAL
OCCLUSION

2. ARTERIAL
OCCLUSION

3. ARTERIAL OCCLUSION
DEFINITION
• It is a condition of acutelack
of tissue perfusion due to
sudden cessation of
circulation.
• Mainaxial artery of thelimb
is blockedpresenting within
minutes to hour after
occlusion.
COMMONSITES
• It is common in lower limb
• upper limb
• Also occur in mesenteric,
cerebral, coronaryarteries.

4. CAUSES
• Embolismis the most
commoncausein developing
country.
• Trauma.
• Thrombosis of an artery
• polycythaemia rubra vera
• thrombocytosis.
• It is commonly observedin
external iliac artery,
profunda femoris arteryand
popliteal artery.

5. PATHOPHYSIOLOGY
• Distal ischaemia
↓
begins immediatelyafteracute
obstruction.
↓
Most sensitive peripheral nerves
are first involved
↓
and thenmuscles, subcutaneous
tissue and skin are affected in
order.
↓
Irreversible ischaemiaoccurs in 6
hours.
↓
Golden period is 1–6 hours.
↓
Ischaemia may get aggravatedby
↓
propagationof thrombus below
and abovethe block
↓
occluding the orifices of
collaterals
↓

6. fragmentationof embolus,
associatedthrombosis, acute
compartment syndrome.
• Acute ischaemia causes
endothelial injuryof
↓
capillaries, arterioles and venules
with luminal obliteration.
↓
Raisedcapillarypermeability
causes fluid leakageinto
extravascular space
↓
forming massive tissue
oedema deepto deepfascia
↓
whichby raising the
intracompartmental
pressure
↓
further reduces the
perfusionleading intoacute
compartment syndrome.

7. CLINICALFEATURES
• Painwhich is continuous,
severe, steady, bursting.
• Pallor of the distal part
withextreme coldlimb.
• Pulselessness—sudden
loss of earlier palpable
pulse.
• Paraesthesia—sensory
disturbances liketingling,
numbness or complete loss
of sensation.
PATHOLOGY

8. • Paresis—damage to motor
nerve and muscle leading
into paralysis as a late grave
feature.
• Poikilothermia—changein
thetemperature (cold).
• Pain, paraesthesia, paresis
are due to ischaemia of
peripheral nerves which are
sensitive to hypoxia.

9. DUETO
TRAUMA/TRAUMATIC
ACUTEARTERIAL
OCCLUSION
CAUSES
• Thrombus due to trauma.
• Subintimal haematoma.
• Acute compartment
syndrome.
• During femoral or brachial
arterial catheterisationfor
either diagnosticor
therapeutic procedures.

10. CLINICALFEATURES
• Historyof trauma
• Pain
• Swelling at the site
• Pallor
• Pulselessness
• Cold limb.
INVESTIGATION
• Duplex scan
• Angiogram
TREATMENT
• Wound is exploredand tear
in the artery is identified.
• Proper antibiotics and
heparin are required to
prevent thrombosis of the
vesseL
ASSOCIAEDFEATURES
• Immediate decompression
by longitudinal fasciotomy
• Haematoma
• Vessel tear has to be
managed accordingly

11. REFERENCE
1. SRB's Manual of Surgery
by SriramBhat M
2. A Manual on Clinical
Surgeryby Das
3. A Concise textbookof
Surgeryby Das

12. A
Special Thanks
To A Very
Special Doctor