Valtimoembolian

Valtimoembolian, commonly translated as arterial embolism, is the sudden occlusion of an artery by an embolus that travels from a distant site or forms in the arterial system. The embolus may consist of thrombus (the most common cause), cholesterol debris, fat, air, or septic material. Arterial embolism differs from venous thromboembolism, which more often causes pulmonary embolism.

Major sources include the left atrial appendage in atrial fibrillation, the left ventricle after myocardial infarction or in cardiomyopathy, and the aortic arch or major branches. Atherosclerotic plaque rupture can release debris that migrates downstream. Risk factors include atrial fibrillation, recent myocardial infarction, heart failure, valvular disease or prosthetic valves, endocarditis, and hypercoagulable states.

Clinically, arterial embolism presents with abrupt ischemia in the affected territory. In limbs this may cause pain, pallor, pulselessness, numbness, weakness, and coldness. When cerebral, coronary, mesenteric, or renal arteries are involved, neurologic deficits, chest or abdominal pain, or reduced organ function may occur. Diagnosis relies on history, exam, and imaging such as duplex ultrasound, CT angiography, or MR angiography, with ECG to identify a cardiac source.

Management requires rapid revascularization and prevention of recurrence. Immediate anticoagulation with intravenous heparin is standard unless contraindicated. Revascularization options include surgical embolectomy, catheter-directed thrombolysis, or mechanical thrombectomy, chosen by location and timing. Long-term prevention targets the underlying cause: anticoagulation for atrial fibrillation, antiplatelet or lipid-lowering therapy for atherosclerosis, and risk-factor modification to reduce recurrence.