Leg Artery Emergencies: Acute Arterial Occlusion

Acute arterial occlusion is serious. It occurs when blood flow in a leg artery stops suddenly. If blood flow to the toe, foot, or leg is completely blocked, the tissue begins to die. This is called gangrene. If this happens, medical care is needed right away to restore blood flow and possibly save the leg. 

Foot and ankle showing bluish color on toes and forefoot.

When Do You Need Emergency Care?

Call your doctor or go to the emergency department right away if you have any of the following:

  • Sudden pain in your leg or foot that may become severe

  • Pale or blue skin

  • Skin cold to the touch

  • Problems moving the foot, leg, or toes

  • No pulse where you used to be able to feel one

Causes of Acute Arterial Occlusion

This problem is more likely to occur in patients with peripheral arterial disease (PAD). With PAD, leg arteries are narrowed. This reduces blood flow to the legs and feet.

How Is Acute Arterial Occlusion Diagnosed?

First, a doctor carefully does an examination. He or she checks the pulses in several different spots. Then, tests on blood flow are done. These tests may include:

  • Ankle-brachial index (ABI). The blood pressure in the ankle is compared to the blood pressure in the arm.

  • Duplex ultrasound. Painless sound waves are used to create images of blood flow in the legs.

  • Arteriography. Contrast (X-ray fluid) is injected into the artery. This is done through a catheter (thin, flexible tube). The contrast makes blood vessels show up more clearly on X-rays.

How Is Acute Arterial Occlusion Treated?

Possible treatments for acute arterial occlusion include:

  • Dissolving or removing a blood clot. A catheter may be put into an artery in the groin to dissolve the clot. The catheter is then used to deliver “clot-busting” medication, which dissolves the clot. Or surgery may be done to remove the clot. An incision is made in the artery at the blocked section. The clot is then removed.

  • Angioplasty. A small, uninflated balloon is passed through a catheter to the narrowed part of the artery. The balloon is then inflated to widen the artery. The balloon is then deflated and removed.

  • Stenting. After angioplasty, a stent (tiny wire mesh tube) may be placed in the artery to help hold it open. The stent is also placed using a catheter.

  • Endarterectomy. An incision is made in the artery at the blocked section. The material that blocks the artery is then removed from artery walls.

  • Peripheral bypass surgery. A natural or man-made graft is used to bypass the blocked section of the artery.

How Can I Protect Myself?

Know the signs and symptoms of an acute arterial occlusion. If you have diabetes or poor circulation, check your feet daily for wounds, sores, blisters, and color changes. Call your doctor right away if you notice problems. If you smoke, stop smoking.