Related Experiment Videos
Changing clinical trends in patients with peripheral arterial emboli
Surgery
|February 1, 1976
Summary
The Fogarty balloon catheter improved outcomes for arteriosclerotic heart disease (ASHD) patients undergoing embolectomy, reducing operative mortality and amputation rates. This technique is a valuable advancement in treating arterial occlusions.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Direct extraction was the primary method for arterial embolectomy before 1964.
- Rheumatic heart disease (RHD) and arteriosclerotic heart disease (ASHD) were common indications for embolectomy.
Purpose of the Study:
- To compare the outcomes of Fogarty balloon catheter embolectomy with direct extraction.
- To evaluate the impact of the Fogarty catheter on operative mortality and limb salvage rates for different patient populations.
Main Methods:
- Retrospective review of 124 patients treated with Fogarty catheter embolectomy (1964-1973).
- Comparison with 82 patients treated with direct extraction (1948-1963).
- Analysis of patient demographics, indications for surgery, operative mortality, and limb salvage rates.
Main Results:
- Fogarty catheter use correlated with a decrease in RHD incidence and an increase in ASHD prevalence.
- Operative mortality for ASHD patients significantly decreased from 74% to 36% with the Fogarty catheter.
- Limb salvage rates were 82% for symptoms <24 hours and 66% for symptoms >24 hours; overall amputation rate was 22%.
Conclusions:
- The Fogarty balloon catheter represents a less stressful and more effective approach to embolectomy, particularly for ASHD patients.
- Lower operative mortality and improved limb salvage highlight the benefits of the Fogarty technique.
- High rates of late mortality due to myocardial infarction in ASHD patients and amputees underscore the systemic nature of their cardiovascular disease.