Arterial occlusion symptoms in acute occlusion may include nocturnal pain when lying down in the area of the feet, acute cold sensation with paling of the extremity or sudden pain when walking, immobilizing after a few meters. In the case of acute arterial occlusion in the legs, there is usually a sudden onset of discomfort or already existing pain suddenly worsens. In the case of chronic arterial occlusion, the symptoms have often existed for a long time and the patient can usually cope with them in everyday life.

The difference between an acute and a chronic arterial occlusion is usually collateralization: in a chronic occlusion, the body has often had enough time to form bypasses, collaterals. If a vessel is acutely occluded, there is no other route for the blood to travel, and the leg is suddenly deprived of adequate oxygen. If the oxygen debt is so great that the leg is in danger of being damaged, immediate action must be taken: the occluded vessel must be reopened. This can usually be done with a catheter intervention. Depending on the localization, however, an arterial occlusion may also have to be treated by surgery.

Chronic occlusion can often remain clinically asymptomatic with good collateral formation. In this case, arteriosclerosis treatment is essential to maintain the status. Therefore, structured walking training also plays a major role in PAOD therapy: regular walks (3 x 30 min. per week) stimulate angiogenesis, i.e. new vessels sprout and surround the occluded vessel segment – similar to a bypass – so that blood flow to the periphery is maintained. The walking distance can thus be significantly improved. This is how circulatory disorders can be treated in the leg area. In stroke treatment, the therapy is primarily with medications in order to reduce the vascular risk factors and blood thinning medications, although collateral circulation can also form here.

What is meant by an arterial occlusion?

In the case of an arterial occlusion, a vessel segment is completely blocked and the blood flow is thus interrupted. Vascular occlusions can affect the entire vascular system. Either a local occlusion occurs on the basis of arteriosclerosis with mostly carry-over of material to the periphery, or the vessel occlusion is caused by an embolism: In chronic atrial fibrillation, small thrombi are formed in the heart and are washed further with the blood flow and become entangled in the vascular system. Depending on the localization, this can result in a stroke or acute limb ischemia.

How common are arterial occlusions?

Arteriosclerosis affects the majority of the population in the western world, especially in older age. As a result, arterial occlusions are a common clinical picture.

What are the symptoms of arterial occlusion?

Symptoms depend on the localization of the arterial occlusion and on the acuity. Arterial occlusion on the brain is accompanied by acute clink: visual disturbances, focal neurological deficits. In the extremities, there is often a sensation of cold and pain, accompanied by sensory disturbances or a loss of strength. Chronic occlusions that are well collateralized often cause fewer problems. Typical in this case is shop window disease. With good training, the symptoms can even improve and the walking distance becomes longer. If an arterial occlusion that is not sufficiently collateralized has existed for a long time, chronic wounds may develop that do not heal adequately.

How is an arterial occlusion treated?

Treatment is based on the acuity and symptoms. Arterial occlusions that are well collateralized and do not significantly restrict extremity supply can be left under medical control and can be treated conservatively. However, if it is an acute occlusion with reduced perfusion, immediate action must be taken or tissue damage will occur: the underlying arterial occlusion must be reopened.

Which doctors treat arterial occlusion?

As angiologists, we have catheter procedures to treat arterial occlusions in the leg area quickly and gently. However, not every localization is amenable to catheter-based intervention. Often, open vascular surgery must be performed.

Are there warning signs and risk factors for possible arterial occlusion?

All vascular risk factors must be mentioned as risk factors: in the first place nicotine consumption! Followed by diabetes mellitus, high blood pressure and hypercholesterolemia. In case of a familial predisposition, these risk factors have to be controlled closely and adjusted optimally. Here, prophylaxis is the best means of preventing arterial occlusion. If the damage is already present, there are typical “precursors”: visual disturbances in one eye, speech disorders, loss of sensitivity. In the area of the legs, the existence of PAOD is a risk for arterial occlusion in the further course.

How can arterial occlusion be prevented?

Patients who are already being treated for a circulatory disorder or who are known to have arteriosclerosis require special medical checks: the vascular risk factors must be regularly controlled and consistently adjusted. An absolute renunciation of nicotine is essential! Arteriosclerosis is a chronic disease that tends to progress. Therefore, the best possible medical treatment of all vascular risk factors is required. With an additional platelet aggregation inhibitor, the tendency to local thromboembolism can be reduced. If high-grade narrowings can be detected by duplex sonography and cause corresponding clinical symptoms, stent implantation is an option to maintain the openness of the vessel.