Practice and theory of "delayed" embolectomy. A 22-year perspective.
A study was made of delayed embolectomy in 45 patients (55 limbs). In 5 patients (11%) the cause of arterial embolization was rheumatic heart disease, and 40 patients (89%) suffered from atherosclerotic cardiovascular disease. The study was divided into 3 phases: I (1960-1964), II (1965-1974) and III (1975-1981). In phases II and III surgery was carried out using the Fogarty catheter technique. In 5 patients the embolus was located in the upper extremity. Seven patients died and 8 major amputations were performed within 30 days of surgery. Use of the Fogarty catheter technique and persistent anticoagulant therapy effected 71.8% limb salvage in phase II and 91.6% limb salvage in phase III. Successful revascularization was achieved in 70.9% of the limbs in which peripheral emboli had occurred on an average of 2.7 days prior to surgical intervention. A theoretical basis for the late development of the acute embolic onset is presented.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D002404:Catheterization / Q000379:methods; D004617:Embolism / Q000601:surgery*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D013997:Time Factors