Lower-limb oedema after thromboembolectomy for acute arterial occlusion

To establish the degree of oedema after thromboembolectomy ad modum Fogarty, leg volume changes were recorded daily in 56 patients. Significant increase was found in the volume of the ipsilateral leg, maximally 12.9 +/- 12% after c. 1 week. The swelling was significantly greater if the popliteal artery had been explored than if it had not. The volume increase was weakly correlated to the duration of ischaemia, but this could be explained by higher incidence of below-knee incisions in patients with longer preoperative ischaemia. Compartment syndrome occurred in one case. The outcome of the operation correlated to leg volume changes on postoperative day 1, but not significantly to the maximal volume increase. It is suggested that the early volume changes represent increased microvascular permeability, and that to this relatively modest oedema is in some cases later added more severe swelling due to impairment of the lymphatic outflow.