Arterial embolism

Treatment

Arterial embolism requires prompt treatment at a hospital. The goals of treatment are to control symptoms and to improve the interrupted blood flow to the affected area of the body. The cause of the clot, if found, should be treated to prevent further problems.

Medications include:

• Anticoagulants (such as warfarin or heparin) can prevent new clots from forming
• Antiplatelet medications (such as aspirin, ticlopidine, and clopidogrel) can prevent new clots from forming
• Painkillers given through a vein (by IV)
• Thrombolytics (such as streptokinase) can dissolve clots

Some people need surgery. Procedures include:

• Bypass of the artery (arterial bypass) to create a second source of blood supply
• Clot aspiration (thromboaspiration)
• Clot removal through a balloon catheter placed into the affected artery or through open surgery on the artery (embolectomy)
• Opening of the artery with a balloon catheter (angioplasty) with or without a stent implanted

Outlook (Prognosis)

How well a patient does depends on the location of the clot and how much the clot has blocked blood flow. Arterial embolism can be serious if not treated promptly.

The affected area can be permanently damaged. Up to approximately 25% of cases require amputation.

Arterial emboli can come back (recur) even after successful treatment.

Possible Complications

• Acute MI
• Infection in the affected tissue
• Septic shock
• Stroke (CVA)
• Temporary or permanent decrease or loss of other organ functions
• Temporary or permanent kidney failure
• Tissue death (necrosis) and gangrene
• Transient ischemic attack (TIA)

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of arterial embolism.

References

Clagett GP, Sobel M, Jackson MR, Lip GY, Tangelder M, Verhaeghe R. Antithrombotic therapy in peripheral arterial occlusive disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3 Suppl):609S-26S.

Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic). Circulation. 2006;113:e463-e654.

Goldman L. Approach to the patient wtih possible cardiovascular disease. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 48.