ABSTRACT
Acute nontraumatic arterial thrombosis continues to be complicated by significant mortality and limb loss. A 3-years experience in the management of 35 patients [43 limbs] with 40 episodes of arterial nontraumatic thrombosis, is reviewed to assess the factors contributing in the final outcome. Almost all the patients presented in this study suffered the manifestations of acute arterial occlusion with subsequent distal ischaemia. The time lapse between the onset and the presentation of the patient was nearly 12 days ranging between 4 hours and 60 days. In 7 patients [20%] the diagnosis was missed for arterial embolism and was corrected by arteriograph [5 patients] and operative findings [2 patients]. The treatment adopted was selective being based on the severity of limb ischaemia, findings in arteriographic examination as will as the patients operative risk. Surgical treatment was adopted in 18 patients [20 limbs] and nonsurgical treatment in 17 patients [23 limbs] with an overall mortality of 10 patients out of 35 [28.6%] and morbidity [including survival amputee] in 10 patients of survivals [40%]. Our limited experience with the use of thrombolytic therapy demonstrated a promising role in limb salvage. It was found that the old age and the site of occlusion were significant predictors for patient's mortality [p<0.05]. The degree of attendant limb ischaemia at presentation was found to be the most significant predictor for limb loss [P < 0.01]. The modality of treatment was found to be a significant factor only when the underlying cause of arterial thrombosis is considered, [P < 0.05] and to a lesser extent the time delay before treatment that was also a predictor for the limb outcome [P = 0.07]