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Acute Arterial Ischemia

Ugent Pathway for Cosmetic Filler Injection

What is  Arterial Ischemia?

Blood flow to and from tissues and organs is critical to their survival as it provides all the necessary elements for metabolism (including oxygen) while also removing all wastes and byproducts. There are two main classes of blood vessels: arteries and veins. Arteries are what deliver oxygenated blood from the heart and lungs to the tissue and veins drain deoxygenated blood back to the heart and lungs for reuse. Arterial ischemia happens when there is a pathologic blockage (partial or complete) of an artery affecting its ability to deliver oxygenated blood to a tissue or organ.

Normal left coronary artery angiography.

What can cause an Arterial Ischemia?

There are many reasons why an artery may become blocked including:

  • Blood clots

  • Atherosclerosis (process of inflammation and damage that thickens the walls of an artery)

  • Calcification of arteries

  • Foreign materials (cosmetic filler)

  • Immune mediated inflammation causing damage (scleroderma, polyderma gangrenosum, graft vs. host disease)

  • Fat embolism (dislodged fat clot)

  • Air embolism (an air clot, typically a complication of a medical procedure)

  • Mechanical compression (such as excess swelling)

  • Pathologic conditions such as sickle cell anemia

  • Others

What are examples of medical problems caused by Arterial Ischemia?

There is a multitude of medical problems that stem from a blockage of an artery including some of the leading causes of death and disability like heart attack and stroke. Some of the main arterial ischemia conditions that can be treated with Hyperbaric Oxygen Therapy include:

  • Central Retinal Artery Occlusion (A clot in the artery of an eye causing sudden vision loss)

  • Problem wounds and ulcers. Click here for more information

  • Problem wounds in sickle cell patients

  • Complications from inter-arterial cosmetic filler injection

  • Crush injury and compartment syndromes causing excessive swelling


There are also significant amounts of ongoing research in the use of Hyperbaric Oxygen Therapy for facilitating the recovery of tissues and organs damaged by a previous sudden or chronic artery blockage including looking at its effect in stroke recovery, traumatic brain injury, and post-concussion syndrome although at this time these are not covered by OHIP.


How does Hyperbaric Oxygen help Arterial Ischemia?


When an artery is blocked (partially or completely) its ability to deliver blood with dissolved oxygen and oxygenated hemoglobin is significantly affected. Oxygen is delivered in two ways throughout the body. First it is bound to hemoglobin (the bodies oxygen carrying protein) and under normal conditions most of the oxygen is delivered by hemoglobin. The second mechanism of oxygen delivery is the amount that is dissolved in blood plasma itself, this typically under normal everyday conditions represents a trivial amount of oxygen delivery. However, through Hyperbaric Oxygen Therapy the amount of oxygen dissolved in the blood plasma can be exponentially increased which is beneficial in conditions of poor arterial blood supply as it helps support oxygen delivery to the affected tissues. Additionally, hemoglobin is a large and bulky protein and therefore dissolved oxygen is able to get through much tighter spaces as in those caused  by artery damage or blockage. In addition to this, Hyperbaric Oxygen Therapy decreases swelling through the direct action of the increased pressure in the hyperbaric chamber. This allows for better flow through an affected artery as the swelling  that may be restricting blood flow is reduced. Hyperbaric Oxygen Therapy also mobilizes progenitor cells (‘stem cells’) through its effect on the hematologic system thus  increasing the amount of these specialized cells needed to promote new blood vessel growth and repair.

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