Acute Arterial Occlusion Definition Is sudden occlusion of

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Acute Arterial Occlusion Definition : Is sudden occlusion of an artery commonly caused by

Acute Arterial Occlusion Definition : Is sudden occlusion of an artery commonly caused by Emboli , or Thrombus. M. A. Kubtan 2

Definition ØEmbolus : Is an abnormal mass of undissolved material which is transported in

Definition ØEmbolus : Is an abnormal mass of undissolved material which is transported in the circulation from one part to another. ØThrombus : Is thrombotic lesion occurs on a plaque of pre-existing atheroma ending with complete acute occlusion of the artery. M. A. Kubtan 3

Classification of Embolism 1. 2. 3. 4. 5. Thrombi and clot may be bland

Classification of Embolism 1. 2. 3. 4. 5. Thrombi and clot may be bland or infected. Gas : Air and Nitrogen. Fat. Tumour. Miscellaneous. M. A. Kubtan 4

Embolic Occlusion Ø It is often a thrombus that has become detached from the

Embolic Occlusion Ø It is often a thrombus that has become detached from the Lt Atrium in cardiac arrhythemia ( atrial fibrellation , or mural thrombus following myocardial infarction. Ø Less common are aneurysm and thrombi formed on atheromatous plaques causing artery to artery embolism. M. A. Kubtan 5

Clinical features of Arterial Occlusion It is an emergency and requires immediate treatment ØLeg

Clinical features of Arterial Occlusion It is an emergency and requires immediate treatment ØLeg >>>> pain , pallor >>>> parisis >>>> pulslessness , paraesthesia ( anaesthesia ). ØThe limb is cold and toes cannot be moved in contrast with venous occlusion when muscle function is not affected. ØThe diagnosis can be made on clinical bases. ØSymptoms may progress to complete loss of function , coldness and mottling. M. A. Kubtan 6

Types of embolism and complications ØCompartment syndrome. ØIntra-arterial thrombosis. ØMesenteric artery occlusion. ØAir embolism.

Types of embolism and complications ØCompartment syndrome. ØIntra-arterial thrombosis. ØMesenteric artery occlusion. ØAir embolism. ØBacterial infected clot embolism. ØMalignant cells ( Hypernephroma , Cardiac myxoma ) ØFat embolism. ØTherapeutic embolisation. M. A. Kubtan 7

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Treatment ØTotal heparinisation ( Intravenous Heparin 5000 U ). ØRelief of pain since it

Treatment ØTotal heparinisation ( Intravenous Heparin 5000 U ). ØRelief of pain since it is sever and constant. ØThrombolysis when indicated. ØEmbolectomy. M. A. Kubtan 11

Abdominal Aortic Thrombosis M. A. Kubtan 12

Abdominal Aortic Thrombosis M. A. Kubtan 12

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Fogarty catheter for removal of Embolus M. A. Kubtan 14

Fogarty catheter for removal of Embolus M. A. Kubtan 14

Removal of organized thrombus M. A. Kubtan 15

Removal of organized thrombus M. A. Kubtan 15

Saddle Aortic Thrombosis M. A. Kubtan 16

Saddle Aortic Thrombosis M. A. Kubtan 16

Thrombus removed from SFA & POP A M. A. Kubtan 17

Thrombus removed from SFA & POP A M. A. Kubtan 17

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GANGRENE ØImplies death of macroscopic portion of tissue ØIt is often affects distal part

GANGRENE ØImplies death of macroscopic portion of tissue ØIt is often affects distal part of limb because of arterial obstruction. ØGas gangrene caused by anaerobic infection. M. A. Kubtan 19

Clinical features Ø Absent arterial pulsation. Ø Absent venous return. Ø Absent capillary response

Clinical features Ø Absent arterial pulsation. Ø Absent venous return. Ø Absent capillary response to pressure. Ø Absent sensation. Ø Absent warmth. Ø Absent function. Ø Changes in colour : Pallor , duscky grey , mottled , purple >>> dark-brown , greenish-black , black. M. A. Kubtan 20

Types of gangrene Ø Dry gangrene. Ø Moist gangrene the affected part becomes swollen

Types of gangrene Ø Dry gangrene. Ø Moist gangrene the affected part becomes swollen , and discoloured. Crepitus may be palpated. this condition is quite common in feet of diabetics. M. A. Kubtan 21

Specific varaieties of gangree �Diabetic gangrene. �Bedsores. �Drug abuse. Injecting of drugs into arteries.

Specific varaieties of gangree �Diabetic gangrene. �Bedsores. �Drug abuse. Injecting of drugs into arteries. �Frost bite. �Venous gangrene M. A. Kubtan 22

M. A. Kubtan 23 te no e Fr th ostb e c it lea

M. A. Kubtan 23 te no e Fr th ostb e c it lea e o r d f th em e ar foo ca t tio nl in

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Treatment of gangrene Ø According to stage. Ø In diabetic gangrene : Oxygenation ,

Treatment of gangrene Ø According to stage. Ø In diabetic gangrene : Oxygenation , Antibiotics , Ø Extensive debridement. Ø Amputation. M. A. Kubtan 26

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