Arterial embolism

Introduction to arterial embolism Arterial embolism is usually caused by embolism, vasoconstriction, vasospasm, and aneurysm. Arterial embolization refers to a blood clot or foreign matter entering a blood vessel that becomes an embolus. As the blood flow stops in an artery of a peripheral artery or a visceral artery with a similar caliber, blood flow is impeded. Arterial embolism is mainly caused by blood clots. In addition, foreign bodies such as tumors, air, and fat may also become emboli. Thrombosis is most common. 90% of blood clots are from the heart, common in rheumatic heart disease, atrial fibrillation and myocardial infarction. Embolism caused by blood clots often occurs in cardiovascular patients. The source of embolism has the following aspects: First, cardiogenicity Many reports indicate that the most common cause of peripheral arterial embolism is cardiogenic. Embolization was 94% of those with heart disease, 77% of which were associated with atrial fibrillation. Arteriosclerotic coronary heart disease, including myocardial infarction, atrial fibrillation, congestive heart failure and parietal aneurysm, accounts for about 60%, and rheumatic heart disease accounts for 20%. Rheumatic heart disease and coronary heart disease, both of which have thrombosis in the left heart. In rheumatic heart disease, especially in mitral stenosis, blood flow in the atria is accompanied by wind-temperature lesions of the intima, and blood fibers tend to adhere to the atrial wall to form a thrombus. Coronary heart disease, especially when myocardial infarction, left ventricular enlargement, weak contraction, and blood can not be empty, is more likely to thrombosis. Second, vascular-derived aneurysms, embolization of atherosclerotic atherosclerosis during arteriosclerosis, has recently been reported to increase. Large embolizations can result from a mixture of large atherosclerotic materials, thrombi, and bile alcohol crystals that fall off into the arterial circulation. Small embolization is caused by the release of bile alcohol crystals or by the shedding of ulcerative arteriosclerotic spots. Third, iatrogenic in recent years, due to the extensive development of cardiac prosthetic valve conversion and artificial blood vessel transplantation, placement of pacemakers, arteriography, hemodialysis arteriovenous fistula, intra-arterial indwelling catheter, aortic counterpulsation balloon catheter application, may Causes arterial embolism. basic knowledge The proportion of illness: 0.0016% Susceptible people: no special people Mode of infection: non-infectious Complications: sinusitis, acute otitis media

Cause of arterial embolism

Cause

1, Western medicine believes

(1) Smoking, nicotine causes vasoconstriction.

(2) Cold stimulation, causing vasospasm.

(3) The hormone level is disordered, causing vasomotor dysfunction.

(4) mold infection, in addition to many years of observation, many patients have had a history of trauma before the onset of illness, some have been injured a few years ago, or even more than 10 years ago. Therefore, it is believed that traumatic blood stasis and chronic persistent infection are also one of the causes. These factors cause small and medium arteriovenous fistulas, non-suppurative inflammation, and increased blood viscosity, leading to thrombosis, even occlusion of blood flow, limb blood supply disorders.

2, Chinese medicine believes

(1) cold and wet invasion, stagnation veins.

(2) Traumatic blood stasis, block the veins.

(3) emotional disorders, qi stagnation and blood stasis. The above factors block the meridians, make the blood and blood run poorly, can not reach the extremities, the limbs lose the warmth of blood and blood, and cause pain, ulceration, and even necrosis are the main pathogenesis of dislocation.

Pathogenesis

The pathogenesis mainly includes the following doctrines:

1 Intimal damage and smooth muscle cell proliferation, release of cell growth factor, leading to thickening of the intima and accumulation of extracellular matrix and lipids.

2 arterial wall lipid metabolism disorder, lipid infiltration and accumulation in the arterial wall:

3 blood flow impact on the shearing force caused by the bifurcation of the artery, or some special anatomical parts (such as the femoral artery adductor muscle tube rupture), resulting in chronic mechanical damage. The main pathological manifestations were atherosclerotic plaque in the intima, degeneration or calcification of the media, and the formation of secondary blood in the lumen, which eventually narrowed the lumen or even completely occluded. Occlusive lesions can be roughly divided into: main-sputum type, femoral-sacral type, and multi-segment type involving the main-iliac artery and its distal artery. Ischemic lesions occur in the affected limb, which can cause limb necrosis in severe cases.

Arterial embolism prevention

Hyperlipidemia, hypertension, smoking, diabetes, obesity, and low-density lipoprotein are low-risk factors and are also the focus of prevention.

Arterial embolization complications Complications, sinusitis, acute otitis media

Acute rhinitis, sinusitis, acute otitis media, lower respiratory tract infection, systemic infection.

Arterial embolism symptoms common symptoms male sexual dysfunction osteoporosis low back pain skin thinning, shiny hair loss, iliac artery beat weakened or disappeared

The severity of symptoms is closely related to the rate of progression of the lesion and the number of collateral circulation. The early symptoms are intermittent claudication, and the distal arterial pulsation is weakened or disappeared, such as the lesion located in the abdominal main-iliac artery. Pain can occur in the lower back, hips, ankles, the back of the thighs, or the calf muscles of the calf, sometimes with impotence, and lesions in the femoral-iliac artery.

Pain occurs in the calf muscles. When the limb is chronically ischemic, the skin shrinks and becomes thin, shiny, osteoporosis, muscle atrophy, hair loss, thickening and deformation of the nail. Rest pain can occur in the later stage, the skin temperature is significantly reduced, cyanosis, gangrene and ulcers at the distal end of the limb.

Arterial embolization

In view of the fact that this disease is a systemic disease, all patients need to be examined in detail:

1 general examination: blood lipid determination, electrocardiogram, heart function and fundus examination.

2 non-invasive vascular examination: ultrasound Doppler blood flow examination and segmental arterial pressure measurement, electrical impedance plethysmography or photoplethysmography, etc., to understand the blood flow of the affected limb. Ultrasound Doppler imaging can show the shape of the blood vessels and blood flow.

3X line film: Sometimes there are irregular calcifications in the diseased arteries, and there are degenerative changes such as osteoporosis in the distal part of the affected limb.

4 angiography: can accurately show the location, extent, extent, collaterals and occlusion of the distal arteries of the lesion, which is of great significance for the selection of surgical methods. Both magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) can achieve the purpose of diagnosis and guidance therapy.

Diagnosis and diagnosis of arterial embolism

Diagnosis can be made by cause, symptoms and related tests.

Arteriosclerotic occlusive disease is similar to the symptoms of thromboangiitis obliterans and needs to be differentially diagnosed. In addition, it should be differentiated from arteritis and arterial embolism.

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