Acute arterial occlusion is a blockage in one of your peripheral arteries that prevents blood from flowing to one of your limbs. It usually occurs in your legs, and blood clots are the most common cause. This is a medical emergency that needs prompt care to restore oxygen to your affected limb and improve your chances of survival.
Acute arterial occlusion is a sudden blockage or closing of one of your peripheral arteries that interrupts blood flow. Healthcare providers also call this condition acute limb ischemia. “Ischemia” means part of your body isn’t receiving enough oxygen-rich blood. When this happens, your tissues quickly become damaged and may soon die.
Acute arterial occlusion may affect any of your limbs (legs or arms). But it usually affects your legs, and it’s often a severe complication of peripheral artery disease (PAD).
This condition is a life-threatening medical emergency that needs immediate medical attention. Without prompt care, you have a higher risk of losing your limb or dying.
Acute arterial occlusion refers to symptoms that start and quickly get worse within a two-week timeframe. You have pain in your limb that doesn’t go away when you rest. You need medical help and treatment right away.
Chronic arterial disease (also called PAD) has symptoms that develop more gradually. Intermittent claudication is a typical symptom you may experience for a while. This cramping or aching feeling in your legs begins when you exercise and stops after you rest for a few minutes. PAD may lead to acute arterial occlusion.
Acute arterial occlusion affects about 1 in 4,500 people. There are no sex-based differences. The median age of diagnosis is 75.
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Symptoms of acute arterial occlusion appear in the affected limb (usually your leg). Healthcare providers refer to the symptoms as the “six Ps.”
An embolism causes sudden and severe symptoms. In other cases, symptoms may show up over several hours or days. The longer your limb goes without oxygen, the more your symptoms will progress. Pain turns into a “pins and needles” feeling, which finally turns into paralysis.
The most common cause of acute arterial occlusion is a blood clot (thrombus) in one of your arteries. A blood clot can form anywhere in your body, but it’s most common in your legs. It’s especially common in your superficial femoral artery, which supplies blood to your lower leg.
Blood clots are more likely to form in an area where you have:
A blood clot may also form in one part of your body and then travel through your bloodstream. This is called an embolus. An embolus can get stuck in one of your arteries and block blood flow. It’s most likely to get stuck in an artery with lots of plaque buildup or at the intersection of two arteries.
The embolus may originate in many different locations. Sometimes, it begins in your heart, including your:
An embolus may also begin in another artery. This is an arterial-to-arterial embolization. It means the blood clot formed in one artery and then traveled to another artery.
Some medical conditions raise your risk of developing acute arterial occlusion. These include:
Other risk factors include:
Diagnosis often begins in an emergency room and includes:
Acute arterial occlusion is a medical emergency that needs a fast and accurate diagnosis. Every minute and every hour make a huge difference in your outcome. An occlusion may cause permanent damage to your limb within four to six hours. That’s why it’s important to seek emergency care immediately if you have symptoms.
Treatment depends on the type of blockage you have, where it’s located and your overall health. Acute arterial occlusion is life-threatening. So, the main goal of treatment is to save your life. Related goals include:
Arterial occlusion often requires a surgery or minimally invasive procedure. A vascular surgeon will evaluate your condition and decide which surgery or procedure you need. You may need more than one. Options include:
Severe cases require amputation. This happens if your limb is too damaged to repair. About 1 in 4 people who survive acute arterial occlusion need an amputation.
As your care team prepares you for surgery, they may give you:
You may not be able to prevent acute arterial occlusion. But some steps you can take to lower your risks include:
Visit your provider for yearly check-ups.
If you have PAD, follow your provider’s guidance on how to manage your condition. There’s no cure for PAD, but you can take steps to slow down its progression. This will help lower your risk of serious complications like acute arterial occlusion.
If you have atrial fibrillation or a history of blood clots, ask your provider if you should be on a blood thinner.
If you have surgery, you’ll begin your recovery in the intensive care unit. Your healthcare provider will investigate the underlying cause of the occlusion to help prevent it from happening again. Your care team will also monitor you for complications, including:
Your provider will tell you if you need to take medications after your surgery. These include:
Your provider will also provide you with detailed instructions on:
Outcomes vary widely from person to person. Acute arterial occlusion is often fatal. About 1 in 4 people don’t survive beyond one year. But with prompt treatment and ongoing medical care, you may be able to recover. Talk with your provider about your prognosis. If you need an amputation, your quality of life will change. But your healthcare team will help you adapt to these changes. Acute arterial occlusion is dangerous, and amputation may be the only way to save your life. Your provider may recommend physical therapy to help you regain your limb function and overall strength.
Life after treatment for acute arterial occlusion isn’t easy. You may feel weak or exhausted. You may also feel stressed or scared. But life is manageable with the help of your care team and your loved ones. Closely follow your healthcare provider’s guidance on how to take care of yourself when you’re back home.
Overall, it’s important to do whatever you can to support the health of your blood vessels and heart. General advice includes:
It’s also important to care for your mental and emotional health. Some tips include:
Your provider will tell you how often you should come in for appointments. Call your provider if you have any new or changing symptoms.
Call 911 or your local emergency number if you experience:
A note from Cleveland Clinic
Acute arterial occlusion is a life-threatening medical emergency. It’s essential to learn the symptoms and seek medical attention right away. Prompt care improves your chances of survival.
If this happens to a loved one, you might feel just as scared as they do. You might also feel powerless. But there’s actually a lot you can do. Stay involved in your loved one’s care, and talk with their healthcare providers. Help them at home as they recover, and assure them they’re not alone. And along the way, educate others in your life about this condition, its symptoms and its risk factors.
Last reviewed by a Cleveland Clinic medical professional on 07/15/2022.
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