3. Arterial Thrombosis

📄Definition

Arterial thrombosis is the formation of a blood clot in an artery, causing partial or complete obstruction of blood flow. It commonly leads to life-threatening events such as:

  • Myocardial infarction (MI) – Coronary artery thrombosis

  • Ischaemic stroke – Cerebral artery thrombosis

  • Acute limb ischaemia – Peripheral artery thrombosis

Pathophysiology

Arterial clots form primarily due to ruptured atherosclerotic plaques in high-flow vessels, leading to platelet-rich (“white”) thrombi.

Virchow’s triad in arterial thrombosis:

  • Endothelial injury – e.g. from hypertension, smoking

  • Hypercoagulability – e.g. antiphospholipid syndrome

  • Turbulent blood flow – e.g. in aneurysms

Risk Factors

🧠 Mnemonic: ATHEROMA

  • Ageing

  • Tobacco use

  • Hypertension

  • Elevated lipids

  • Renal dysfunction

  • Obesity

  • Male sex

  • Atrial fibrillation (embolic risk)

🩺Clinical Features

Depend on the location:

  • Coronary: Chest pain, dyspnoea, syncope

  • Cerebral: Facial droop, slurred speech, unilateral weakness

  • Peripheral: Pain, pallor, pulselessness, paralysis, paraesthesia

Management

🧠 Mnemonic: ACT FAST

  • Aspirin (antiplatelet)

  • Clopidogrel or dual antiplatelet therapy (DAPT)

  • Thrombolysis (e.g. alteplase) – for stroke if within time window

  • Fibrinolysis (in STEMI or major embolism, if PCI not available)

  • Angioplasty / PCI or stenting (urgent)

  • Statin initiation

  • Treat underlying cause (e.g. hypertension, diabetes)

⚠️ Complications 

  • Myocardial infarction

  • Stroke

  • Critical limb ischaemia → amputation

  • Death

🔺 Last updated in line with NICE Clinical Knowledge Summary – Arterial Thrombosis
Published: January 2020 • Last updated: June 2023
Last reviewed: July 2025
✅ PASSMAP ensures all content is NICE-aligned and reviewed for Physician Associate Registration Assessment (PARA) success.

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