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Classification: Arterial
Classification: Arterial
vessel.[1] The embolus may be a blood clot (thrombus), a fat globule (fat embolism), a bubble of air or
other gas (gas embolism), or foreign material. An embolism can cause partial or total blockage
of blood flow in the affected vessel.[2] Such a blockage (a vascular occlusion) may affect a part of the
body distant to the origin of the embolus. An embolism in which the embolus is a piece of thrombus
is called a thromboembolism.
An embolism is usually a pathological event, i.e., accompanying illness or injury. Sometimes it is
created intentionally for a therapeutic reason, such as to stop bleeding or to kill a cancerous tumor
by stopping its blood supply. Such therapy is called embolization.
Classification[edit]
There are different types of embolism, some of which are listed below.
Embolism can be classified as to where it enters the circulation either in arteries or in veins. Arterial
embolism are those that follow and, if not dissolved on the way, lodge in a more distal part of
the systemic circulation. Sometimes, multiple classifications apply; for instance a pulmonary
embolism is classified as an arterial embolism as well,[3] in the sense that the clot follows
the pulmonary artery carrying deoxygenated blood away from the heart. However, pulmonary
embolism is generally classified as a form of venous embolism, because the embolus forms in veins,
e.g. deep vein thrombosis.
Arterial[edit]
Main article: Arterial embolism
Arterial embolism can cause occlusion in any part of the body. It is a major cause of infarction, tissue
death due to the blockage of blood supply.
An embolus lodging in the brain from either the heart or a carotid artery will most likely be the cause
of a stroke due to ischemia.
An arterial embolus might originate in the heart (from a thrombus in the left atrium, following atrial
fibrillation or be a septic embolus resulting from endocarditis). Emboli of cardiac origin are frequently
encountered in clinical practice. Thrombus formation within the atrium occurs mainly in patients
with mitral valve disease, and especially in those with mitral valvestenosis (narrowing), with atrial
fibrillation (AF). In the absence of AF, pure mitral regurgitation has a low incidence of
thromboembolism.
The risk of emboli forming in AF depends on other risk factors such as age, hypertension, diabetes,
recent heart failure, or previous stroke. Thrombus formation can also take place within the ventricles,
and it occurs in approximately 30% of anterior-wall myocardial infarctions, compared with only 5% of
inferior ones. Some other risk factors are poor ejection fraction (<35%), size of infarct, and the
presence of AF. In the first three months after infarction, left-ventricle aneurysms have a 10% risk of
emboli forming.
Patients with prosthetic valves also carry a significant increase in risk of thromboembolism. Risk
varies, based on the valve type (bioprosthetic or mechanical); the position (mitral or aortic); and the
presence of other factors such as AF, left-ventricular dysfunction, and previous emboli.
Emboli often have more serious consequences when they occur in the so-called "end circulation":
areas of the body that have no redundant blood supply, such as the brain and heart.
Venous[edit]
Further information: Pulmonary embolism
Further information: Thrombosis prophylaxis
Assuming a normal circulation, an embolus formed in a systemic vein will always impact in the lungs,
after passing through the right side of the heart. This will form a pulmonary embolism that will result
in a blockage of the main artery of the lung and can be a complication of deep-vein thrombosis. The
most common sites of origin of pulmonary emboli are the femoral veins. The deep veins of the calf
are the most common sites of actual thrombi.
Direction[edit]
The direction of the embolus can be one of two types:
Anterograde
Retrograde
In anterograde embolism, the movement of emboli is in the direction of blood flow. In retrograde
embolism, however, the emboli move in opposition to the blood flow direction; this is usually
significant only in blood vessels with low pressure (veins) or with emboli of high weight.