Arteries can become occluded by atherosclerotic plaque, thrombi, or emboli. The most common cause of acute arterial insufficiency is embolization, with cardiac sources accounting for more than 70% of emboli. Subsequent obstruction and damage to the vessels can follow chemical or mechanical trauma and infections or inflammatory processes. Arteriosclerosis obliterans is marked by plaque formation on the intimal wall of medium-sized arteries, causing partial occlusion. In addition, there is calcification of the media and a loss of elasticity that predisposes the patient to dilation or thrombus formation. Thromboangiitis obliterans (Buerger disease), which is characterized by an inflammatory infiltration of vessel walls, develops in the small arteries and veins (hands and feet) and tends to be episodic. Risk factors include hyperlipidemia, hypertension, and smoking.

Arterial Occlusive Disease 103

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