This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 16. Cardiovascular Disorders Chapter 212. Peripheral arterial occlusion may result in acute or chronic ischemia.
Chronic ischemia is caused by gradual enlargement of an atheromatous plaque.
The major risk factors for atherosclerosis include hypertension, elevated levels of low density lipoprotein, reduced levels of high density lipoprotein, cigarette smoking, diabetes mellitus, obesity, male sex, elevated homocysteine levels, and family history of premature atherosclerosis. Sustained elevation of blood homocysteine, by damaging endothelial cells, predisposes to premature atherosclerosis of the aorta and its branches, the peripheral arteries, the cerebral arteries, and possibly the coronary arteries. Although homocysteine levels are usually elevated in association with other risk factors, they can be modified by diet and vitamin B supplements. Symptoms, Signs, and Diagnosis Clinical syndromes of arterial occlusion depend on the vessel involved, the extent of obstruction, how rapidly occlusion progresses, and whether collateral flow is adequate. The extremity is cold and pale, and pulses are absent distal to the obstruction.