MANAGEMENT OF ACUTE THROMBOEMBOLIC LIMB ISCHEMIA

  • 1 January 1983
    • journal article
    • research article
    • Vol. 93  (3) , 381-385
Abstract
Acute arterial occlusion affecting the extremities remains a significant cause of death and limb loss. Approach to the management of these patients have been selective, and they are based upon a clinical distinction between embolism and thrombosis. Patients with acute embolic occlusion are treated with prompt embolectomy; patients with thrombosis are given a course of heparin therapy, followed by elective arterial repair if necessary. Deterioration of the limb is an indication for emergency reconstruction, and nonviable limbs are amputated early. This approach to treatment was assessed in a 1-yr prospective study involving 29 patients with embolism and 50 patients with thrombosis. The initial diagnosis was found to be incorrect for 7 patients (8.9%). Of the patients with embolism, 4 died (13.8%) and 3 required amputation (10.4%). There were 6 deaths (12%) among the patients with thrombosis, but 11 required amputation (22%), and, in 7 of these, amputation was the definitive treatment. Apparently, the selective use of surgery is an appropriate method of treatment for patients with acute thromboembolic limb ischemia.