Arterial Thrombosis (Clot In The Artery)

Blood clots (thrombosis) more commonly form in veins than arteries, due to the slower flow in veins. There are a number of scenarios that can cause blood clot to form in arteries, and these either form directly in the affected artery, or form upstream and shoot downstream carried by the blood flow to block a specific artery:

• Blood clot that develops on an atherosclerotic plaque that ruptures (‘in situ’ disease or ‘plaque rupture’) and causes blockage of that artery
  • This clot that develops can either remain at the site of origin, or ‘shoot’ off (embolise) downstream
• Blood clot that develops from injury to the artery from trauma/surgery/angiogram
• Blood clot that develops elsewhere in the arterial circulation (commonly sites include the heart in setting of irregular heart beat/heart attack, within the wall of an aneurysm, atherosclerotic plaque) and ‘shoots’ (embolises) downstream to cause blockage
• Blood clot that develops in the leg as DVT, and embolises into the lungs
• Blood clot that develops in the leg as DVT, and bypasses the lungs into the arterial circulation

Certain conditions can predispose to the development of arterial thrombosis

• Hereditary clotting disorders (Factor V Leiden, Antiphospholipid syndrome, prothrombotic disorders or thrombophilia)
• Active cancer

An arterial clot usually presents as a sudden pain/dysfunction in the area/organ’s artery that is blocked. This usually results in intense pain in the region and if critical and blood flow is not restored, this can lead to permanent dysfunction. Common sites of arterial thrombosis include:

• Lower limbs
• Upper limbs
• Gut
• Brain
• Lung
• Solid organs – kidneys, spleen, adrenal glands

This is often a surgical emergency which is time critical and we are available at all times for our patients. In appropriate cases, our aim is to remove the clot as soon as possible to restore blood flow to the threatened limb or organ. This can be done surgically and in certain cases with minimally invasive endovascular techniques. In some cases, surgery is not required and treatment with blood thinning is all that is required.

It is often crucial to initiate blood thinning (thrombolytic, anticoagulation or anti platelet) medication as an indefinite treatment in order to prevent the clot from recurring.
Specialised investigations are often required to determine the likely cause of the arterial thrombosis. Early engagement and involvement of blood specialists (Haematologist) and physician colleagues is vital in managing the underlying condition and preventing further thromboses from occurring.