The so-called arterial embolism, which is usually acute in onset, is a pathological process in which an embolus is dislodged from the heart or proximal arterial wall, or enters the artery from outside and is washed distally by the blood flow, blocking the arterial blood flow and causing ischemia or even necrosis in the corresponding limb or internal organ.
Common causes of arterial embolism
Arterial embolism emboli can be composed of blood clots, atherosclerotic plaques, bacterial fibrin coagulation, air, tumor tissue, foreign bodies (such as shrapnel), broken catheters or guidewires, amniotic fluid and fat, etc. The left atrial thrombus is the most common.
What are the manifestations of arterial embolism?
The most common manifestations of arterial embolism are
1, pain: severe pain in the affected limb is the main symptom of most patients with arterial embolism;
2.No pulse: The pulse of the artery below the embolism site cannot be touched or is weakened;
3, pale, syncopal cold: due to tissue ischemia, the skin papillary layer under the venous plexus blood emptying appear waxy white;
4, numbness, movement disorder: is the most important clinical manifestation to judge the disease process, often manifested as having or about to have muscle necrosis.
What is the serious harm of arterial embolism to the body?
Changes in the affected limbs: due to tissue hypoxia, peripheral nerves are the most sensitive to hypoxia, followed by muscle tissue, thus pain and numbness are the earliest clinical manifestations of arterial embolism in the limbs. Cardiovascular system and systemic effects: Most cases suffer from cardiovascular system diseases, and arterial embolism aggravates the original cardiovascular disorder, which can lead to blood pressure drop, shock, severe arrhythmia and even cardiac arrest in severe cases.
Why is it important to raise awareness about arterial embolism disease?
There are three reasons for concern about arterial embolism.
1.As the aging population increases, heart disease and atherosclerotic disease are increasing year by year, so the number of cases of atheroembolism is also increasing;
2, the medical knowledge of middle-aged and elderly people and the clinicians’ awareness of arterial embolism are not enough, and the clinical cases of delayed diagnosis and treatment due to arterial embolism are often encountered;
3.Arterial embolism is a kind of dangerous emergency, if not diagnosed in time, it can be a light surgical amputation or a life-threatening disease. Therefore, it is an important job for vascular surgeons to educate about arterial embolism.
What kind of people should pay special attention to arterial embolism?
Middle-aged and elderly people, people with high blood pressure, high blood lipid, high viscosity, high smoking addiction, especially for people with coronary heart disease, heart attack, atrial fibrillation, atherosclerosis and abdominal aortic aneurysm are the people with high risk of arterial embolism. In addition, arterial injury, malignant tumors and cardiac mucus aneurysms, are also causes of atheroembolism.
What are the most frequent sites of arterial embolism?
According to clinical statistics, arterial embolism is most common in the lower extremity, most commonly in the femoral artery, followed by the iliac artery and abdominal aortic bifurcation, and 3/4 of the upper extremity arteries occur in the brachial artery, in addition, abdominal visceral arteries may also occur, and the most common manifestation is small bowel necrosis caused by mesenteric artery embolism.
When encountering a patient with suspected arterial embolism in clinical practice, what tests are commonly used to make the quickest diagnosis?
When encountering a patient with suspected arterial embolism in the limb, the general vascular surgeon will usually touch the distal pulse, and if there is no pulse, it is highly suspicious. The common auxiliary tests are arterial flowmetry, color ultrasound and CT angiography, which can check whether there is still blood flow in the arterial vessels and also see the emboli in the arteries. In addition, vascular surgeons use arteriography in their treatment to assess the site and extent of the embolized artery and to treat it at the same time.
Treatment after an arterial embolism occurs
The affected limb is placed below the plane of the heart, usually about 15° down, to facilitate the flow of arterial blood into the limb. Room temperature should be kept around 27°C. Local hot compresses should not be used to avoid enhanced tissue metabolism and aggravated hypoxia. Local cold compresses can cause vasoconstriction and reduce blood supply, which should also be contraindicated.
Prognosis of arterial embolism
The prognosis of arterial thrombosis is related to a variety of factors, the most important of which is the adoption of correct therapeutic measures and the length of time from the onset of the disease. The limb survival rate can be up to 95% if treated within 6 hours of onset; 80% if treated within 12 hours; 60% if treated within 12-48 hours; and should be treated immediately once the diagnosis is clear.