Arterial occlusion is usually the result of long-term arteriosclerotic processes, in which increasing deposits in the vessels first lead to the narrowing and finally to the occlusion of a blood vessel.
In general, such arterial occlusions are possible in all organs, but occur more frequently in the legs, heart, brain or eyes. Such an occlusion ultimately leads to reduced blood flow and thus to reduced oxygen supply in a tissue or organ.
Arterial occlusion is essentially a systemic vascular disease of the arteries. As a result of arteriosclerosis, arterial stenosis develops over time and eventually the vessel becomes completely blocked.
This results in a reduced supply of arterial, oxygen-rich blood, which leads to a lack of oxygen in the supplied tissue. Peripheral arterial occlusive disease(PAOD) or coronary heart disease are typical clinical pictures of this.
Acute arterial occlusion, on the other hand, interrupts the blood supply to the tissue supplied by the artery in question, leading to a lack of oxygen and the risk of damage. Examples include heart attacks, in which an arterial blockage occurs in the coronary arteries of the heart, or strokes, in which a cerebral vessel is blocked.
The cause of such acute events is usually blood clots (thrombi), which can become detached from the left heart, e.g. from a deep vein thrombosis in the leg or in the case of cardiac arrhythmia (e.g. atrial fibrillation), and then cause a stroke, heart attack or pulmonary embolism by blocking an artery. These three events are life-threatening emergencies.
Illustration of a vascular occlusion © pankajstock123 #63446706 | AdobeStock
The arteries in the legs are often affected - medical professionals refer to this as peripheral arterial occlusive disease, or PAD for short. PAD is characterized by a stabbing pain in the affected leg after a comparatively short distance (= pain on exertion) and an apparent recovery after a certain period of rest. This symptomatology ultimately gave the disease its colloquial name - intermittent claudication - as short distances are interrupted by numerous breaks in walking, similar to window shopping.
In addition, the arteries of the heart (= coronary arteries) can be affected and lead to the clinical picture of the "narrow chest" (= coronary heart disease).
There are also arterial occlusive diseases in the area of the brain, the eyes and the kidneys (= renal artery stenosis).
Initially, arterial occlusions cause very few symptoms, which usually manifest themselves in stressful situations. In the case of PAOD, for example, there is pain on exertion, in the case of coronary heart disease there is "tightness in the chest" (= angina pectoris) with shortness of breath and pain, in the case of occlusions in the renal arteries, blood pressure usually rises.
However, these slowly progressing occlusive diseases must be distinguished from acute arterial occlusion, which is an emergency situation. This leads to severe pain in the legs, loss of pulse below the occlusion site and pale skin coloration.
A heart attack, on the other hand, is characterized by pain, anxiety and shortness of breath. A stroke, on the other hand, is characterized by symptoms such as speech disorders, facial and body paralysis, dizziness and severe headaches, depending on the region of the brain affected.
Doctors obtain the first indications of arterial occlusion from the patient's medical history and physical examination if they are already showing symptoms such as shortness of breath, pain on exertion or chest tightness.
The next step is imaging, for which ultrasound and Doppler ultrasound are primarily used to visualize the flow conditions in the arteries.
If coronary artery involvement is suspected or in the case of cardiac arrhythmia, an electrocardiogram (ECG for short) is performed. Angiography, magnetic resonance imaging(MRI) and computer tomography(CT) also enable comprehensive imaging, e.g. of the brain or heart.
While occlusive disease, which is still developing, can usually be slowed down by taking more exercise, eating more consciously and avoiding nicotine and alcohol, the threat of complete or already acute arterial occlusion must be treated in hospital.
The main aim here is to dissolve the blockage in the artery as quickly as possible in order to restore the blood supply to the tissue or organ. Heparinization is usually carried out with medication, i.e. an attempt is made to open the vessels with the help of anticoagulants.
If there is a high risk of heart attack, such as in coronary heart disease, doctors try to place stents to widen the arteries and keep them open, or a bypass operation is performed.
Left: an impending vascular occlusion, right: widening with a stent © crevis #89836026 | AdobeStock
In the latter operation, the blocked section of artery is shut down with the help of several "bypass circuits" and the blood flow to the heart muscle is redirected into new channels. However, without a subsequent change in diet and more exercise in everyday life, the arterial occlusive disease will also block these bypasses after some time.
Vascular diseases such as arterial occlusive disease are treated by specialists in internal medicine, cardiology and/or angiology (vascular medicine). You can find the relevant experts and clinics in your area here.
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