Management of Acute Arterial Occlusion

By Carolyn Kisner PT, MS and Lynn Allen Colby PT, MS on February 9th 2009

Acute arterial occlusion often is a medical or surgical emergency. The resulting ischemia causes severe pain, the risk of tissue necrosis and local or systemic infection, and the possible need for amputation. The viability of the limb depends on the location and extent of the occlusion and the availability of collateral circulation.

Medical or surgical measures must be taken to reduce ischemia and to restore circulation. Medical management includes bed rest and complete systemic anticoagulation therapy. Complementary physical interventions to improve peripheral blood flow while the patient is on bed rest may include warming the limb by reflex heating of the torso or opposite extremity or elevating the head of the bed slightly.

Contraindications with Acute Arterial Occlusion

· Exercise-passive or active

· Prolonged positioning during bed rest, which could cause pressure on and potential breakdown of skin

· Local, direct heat on the involved extremity because of the potential for a burn to the ischemic tissue

· Use of support hose, which may increase peripheral resistance to blood flow

· Restrictive clothing that could compromise blood flow

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