What is the most likely diagnosis for a 70-year-old female with sudden onset left lower extremity pain and absent pulses?

The presentation of a 70-year-old female with sudden onset left lower extremity pain and absent pulses strongly suggests an acute arterial occlusion. This condition typically occurs due to a thrombus or embolus that abruptly interrupts blood flow to a limb, leading to critical ischemia. The sudden nature of the pain, combined with the absence of pulses in the affected extremity, indicates a significant loss of blood supply that can result in tissue necrosis if not promptly addressed.

In acute arterial occlusion, patients often describe the pain as severe and may also exhibit additional signs such as coldness, pale skin, and motor deficits in the affected limb. Immediate evaluation and intervention are crucial, as this condition can lead to irreversible damage or loss of the limb if not treated rapidly.

Other conditions like thromboangiitis obliterans are generally seen in younger male smokers and would present with different clinical features and a more chronic course, while deep vein thrombosis would typically not cause absent pulses but rather swelling and pain due to venous obstruction. Peripheral neuropathy generally leads to numbness or tingling and does not usually result in acute pain with absent pulses, making it less likely in this scenario. All of these factors together confirm that an acute arterial occlusion is the