Hodara M
J Mal Vasc. 1983;8(1):101-5.
The most frequent cause of acute ischaemia of the lower limbs is arterial: thrombotic, embolic and spastic. In cases of arterial embolism, the site of origin is the left side of the heart in 9 cases out of 10: ischaemic heart disease in 2/3 of cases, with atrial fibrillation (A.F.) in 50% of cases, rheumatic valvular disease with A.F. in 1/5 of cases and more rarely, idiopathic A.F., auricular disease and cardiomyopathies. Arterial emboli can be fragments from a wall thrombus (aortic or arterial aneurysm), or atheromatous material from an ulcerated plaque. In 11% of cases the origin of the embolus is never found. Arterial thrombosis is due to chronic vascular disease in 1/3 of cases, popliteal aneurysm and thromboangiitis obliterans. The iatrogenic causes are rare: use of the arterial route, and arterial prosthesis, accidental intra-arterial injection during sclerotherapy for varicose veins. Arterial spasm is seen in cases of phlegmatia caerulea dolens. It ben be iatrogenic (ergotamine tartrate, dihydroergotamine, methysergide), toxic (L.S.D.) or spontaneous.
血栓形成、栓塞和痉挛。在动脉栓塞病例中，十分之九的栓子起源于心脏左侧：三分之二的病例患有缺血性心脏病，其中50%伴有心房颤动（房颤），五分之一的病例患有风湿性瓣膜病并伴有房颤，更罕见的是特发性房颤、耳部疾病和心肌病。动脉栓子可以是壁血栓（主动脉或动脉瘤）的碎片，也可以是溃疡斑块的粥样物质。11%的病例栓子来源始终不明。三分之一的动脉血栓形成病例是由慢性血管疾病、腘动脉瘤和血栓闭塞性脉管炎引起的。医源性原因较为罕见：动脉途径的使用、动脉假体、静脉曲张硬化治疗期间意外的动脉内注射。在蓝色血栓性静脉炎病例中可见动脉痉挛。它可能是医源性的（酒石酸麦角胺、二氢麦角胺、甲基麦角新碱）、中毒性的（麦角酸二乙胺）或自发性的。
