Peripheral arterial embolism: 1961-1985

A review of arterial embolism to upper and lower limbs from 1961 to 1985. During this period 253 patients were treated for 269 episodes of embolus at the Princess Alexandra Hospital. The period was divided into 5 year intervals and analysis showed significantly increasing age for the population over this period. Similarly a decreasing mortality rate was noted during this period although limb salvage did not change after the initial 5 year period. There was a rising incidence of atherosclerotic ischaemic heart disease and a decreasing incidence of rheumatic heart disease. The overall mortality rate was 15.6% while the overall amputation rate was 8.2%. Factors significantly related to survival were acute myocardial infarction and level of occlusion. Factors significantly relating to morbidity were pre-operative heparin administration and performance of completion angiography. The performance of completion angiography was shown to improve the result from embolectomy without having adverse influence on the mortality rate. The results of this review indicate that preoperative heparinization, the performance of completion angiography, and the flexibility to explore multiple levels of the limb circulation, are essential factors in the management of peripheral arterial embolism.