ARTERY EMBOLISM OF UPPER LIMBS

  • 1 January 1977
    • journal article
    • research article
    • Vol. 81  (4) , 367-375
Abstract
An analysis of 256 consecutive patients with a total of 260 arterial emboli to the upper limbs treated during the 35 yr period from 1939-1974. Cardiac diseases were the causes of embolism in 92.58% of these patients. Mild ischemia of the limbs was revealed only in 33.82% of the patients. Severe ischemia accompanied by significant restriction or full absence of active movements in the joints of affected extremities was observed in 55.94% of the patients. Acute ischemia with a muscular edema and partial or total contracture was observed in 9.88% of the patients; 47 patients were treated conservatively. Arteriectomy was performed in 3 patients. Embolectomy was carried out on 206 patients, 101 of whom were operated on by means of the approach outside the cubital fossa and 105 by means of the antecubital approach. The best results were obtained when embolectomy was performed with the use of the Fogarty catheter by means of the antecubital approach. This method achieved full restoration of circulation in 91.59% of the patients. The mortality rate was approximately equal in all groups of patients. Recurrent embolism of cerebral and mesenteric arteries was the main cause of death. Fatal postischemic complications led to the death of 2 patients who were operated on with a total ischemic contracture of a limb. Autopsy revealed a pulmonary microembolism in one case and a myoglobinuric nephrosis in the other.

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