[Clinical aspects of arterial insufficiency of the lower extremities. Side-branch thrombosis and arterio-arterial embolism]

Abstract

Branch thrombosis is an occlusion of an arterial branch while the main artery driving blood into the limb is normal. This situation may be observed in iliaca interna or femoralis profunda arteries; ankle systolic pressure is normal despite typical intermittent claudication. Diagnosis of branch thrombosis must be confirmed by arteriography. There are 3 different kinds of arterio-arterial emboli, i.e. emboli coming from proximal arterial wall: (1) emboli deriving from an arterial aneurysm, (2) emboli of atheromatous plaques, often caused by an invasive medical procedure, and (3) cholesterol emboli, often spontaneous, occluding 50-500 micron diameter arteries. Clinically, the disease resembles vasculitis and may simulate periarteritis nodosa.