Upper limb embolus: a timely diagnosis

In a ten year period, 36 patients were treated surgically for embolic occlusion of upper limb vessels. The sources of embolus were cardiac (58%), peripheral aneurysm (22%) and unknown (20%). Brachial embolectomy was performed in all cases. Six out of eight peripheral aneurysms were resected. A patency rate of 94% was achieved at five years. Hospital mortality and morbidity rates were 3% and 10%, respectively. One patient died of a myocardial infarct one week postoperatively. Three patients suffered ischemic contracture or amputation; all three presented after 36 hours. We conclude that upper limb emboli are usually easy to recognize and treat. Prompt surgery (less than 24 hours) produces the most satisfactory results. Late presentation or delay in treatment can result in limb loss.