Acute bilateral lower extremity arterial occlusion without risk factors or embolic source

Acute arterial occlusion is an emergency condition that, if untreated, can lead to serious complications and potential limb amputation. Risk factors for acute arterial occlusion include aortic atherosclerosis, arterial trauma, recent myocardial infarction, and atrial fibrillation. We present a patient with no history of peripheral vascular disease who presented to the emergency department with severe bilateral leg pain. Computed tomography angiography was performed showing bilateral acute arterial occlusions. Emergent vascular surgery was performed to remove the thrombus and establish perfusion in order to prevent bilateral lower leg amputation.