Acute peripheral arterial embolism: a 3-year experience with 81 cases

ABSTRACT

The clinical course of 81 patients, who had acute peripheral arterial embolism who were treated at Ain Shams University Hospitals between January 1989 and January 1992, was reviewed. There were 52 females and 29 males. The average age of female patients was 47.6 years and that of the male patients was 52.5 years. The incidence of rheumatic heart disease as a source of embolism in our patient population is still high accounting for 40 percent of the embolic episodes. Atherosclerotic coronary disease with its sequelae was responsible for 58 percent of the embolic episodes upper limb emboli were less common than lower limb emboli constituting 18.5 percent. Acute peripheral embolism, in this study, was diagnosed mainly on clinical basis and treated with prompt balloon catheter embolectomy. Pre-operative arteriography is indicated when the diagnosis of local thrombosis is questioned. Completion intra operative angiography is mandatory to assess the completeness of the procedure and to plan further exposures if necessary. Multiple emboli occurred in 22 patients and embolism recurred in 10 patients. All patients were permanently anticoagulated to reduce the recurrence rate. Seventeen patients died in the postoperative period [immediate mortality rate 21 percent]. Of the surviving 64 patients, above knee ampulation was required in 3 cases