Acute peripheral arterial occlusion may result from: Rupture and thrombosis of an atherosclerotic plaque Embolus from the heart or thoracic or abdominal aorta Aortic dissection Acute compartment syndrome Symptoms and signs are sudden onset in an extremity of the 5 P's: P ain (severe) P allor P aresthesias (or anesthesia) P olar sensation (coldness) P ulselessness The occlusion can be roughly localized to the arterial bifurcation just distal to the last palpable pulse (eg, at the common femoral bifurcation when the femoral pulse is palpable; at the popliteal bifurcation when the popliteal pulse is palpable).