Peripheral arterial embolectomy, risks and results.
Embolectomy of the extremities was performed on 221 patients (263 emboli) with median age 77 years. The upper extremity was affected in 21% of cases. No correlation was found between the time from onset of symptoms to embolectomy and the amputation rate. There were 81 deaths (37%) within a month of operation. The mortality rate was significantly higher (47%) among the patients who were already in hospital when embolism occurred and also when the embolism was associated with myocardial infarction (68%). Among patients given oral anticoagulants postoperatively the perioperative mortality was 5%, compared with 51% without such medication. Patient age, concomitant coronary artery disease and oral anticoagulant treatment were factors independently influencing morbidity during the first postoperative month. The 5-year survival rate was also significantly heightened by anticoagulant treatment (43 vs. 12%). Data concerning amputation rate, perioperative mortality and long-term survival in relation to oral anticoagulant treatment must be cautiously interpreted. Prospective trials are required to answer some of the questions.
Takolander
R
R
Department of Surgery, University of Lund, General Hospital, Malmö, Sweden.
Lannerstad
O
O
Bergqvist
D
D
D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000767:Anesthesia, Epidural; D000772:Anesthesia, Local; D001132:Arm / Q000601:surgery; D004617:Embolism / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors