Acute arterial embolism of the lower extremities: impact of 24-hour duration on the outcome of management.
OBJECTIVE
Determine the impact of 24-hour duration of arterial embolism on the outcomes of management.


METHODS
A prospective study of 91 patients with acute arterial embolism of the lower extremities was carried out.


RESULTS
Among the 91 patients, 31(34.1%) were with early acute embolism(< 24 hours) and 60 (65.9%) were with late acute embolism (> 24 hours). Extensive limb gangrene was more common in patients with late acute embolism (26.7% versus 3.2%, p = 0.009). Subsequently, primary major amputation was higher in those patients (20% versus 3.2%, p = 0.05). In early acute embolism, surgical embolectomy was only the primary treatment of revascularization (87.1%) whereas in late acute embolism, there were varying modalities of revascularization (68.3%) in addition to surgical embolectomy. The successful revascularization after the initial surgical embolectomy was significantly higher in patients with early acute embolism (92.6% versus 43.9%, p < 0.001). Patients with late acute embolism had a higher tendency of undergoing major amputation after revascularization (24.4% versus 7.4%, p = 0.106). Successful outcome was higher in patients with early acute embolism (83.9% versus 58.3%, p = 0.014).


CONCLUSIONS
The 24- hour duration of arterial embolism may be a crucial factor influencing the outcome in the management of this disease.
Vascular Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. pramook_siriraj@hotmail.com
Pramook
P
Mutirangura
Chanean
C
Ruangsetakit
Chumpol
C
Wongwanit
Nuttawut
N
Sermsathanasawadi
Khamin
K
Chinsakchai
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017128:Embolectomy; D005260:Female; D005734:Gangrene / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D007511:Ischemia / Q000401:mortality / Q000601:surgery*; D035002:Lower Extremity / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D012307:Risk Factors; D013534:Survival; D013923:Thromboembolism / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome