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Peripheral arterial embolism: 1961-1985
The Australian and New Zealand Journal of Surgery
|January 1, 1987
Summary
This review of arterial embolism management found that while mortality rates decreased, limb salvage remained stable. Key factors for survival include prompt treatment and angiography, improving outcomes for peripheral arterial embolism patients.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Public Health
Background:
- Arterial embolism to the limbs is a significant cause of morbidity and mortality.
- Understanding trends in incidence, treatment, and outcomes is crucial for improving patient care.
Purpose of the Study:
- To review the management and outcomes of arterial embolism to the upper and lower limbs over a 25-year period.
- To identify factors influencing survival and limb salvage in patients with peripheral arterial embolism.
Main Methods:
- Retrospective review of 253 patients treated for 269 episodes of arterial embolism between 1961 and 1985.
- Analysis of demographic data, treatment strategies, and outcomes, stratified by 5-year intervals.
Main Results:
- A significant increase in patient age and a decrease in mortality rate were observed over the study period.
- Limb salvage rates did not change significantly after the initial 5-year period. Atherosclerotic heart disease incidence rose, while rheumatic heart disease incidence declined.
- Overall mortality was 15.6%, and amputation rate was 8.2%. Acute myocardial infarction and level of occlusion were linked to survival. Pre-operative heparin and completion angiography improved morbidity outcomes.
Conclusions:
- Preoperative heparinization and completion angiography are essential for managing peripheral arterial embolism.
- Flexible surgical approaches to address multiple levels of limb circulation improve embolectomy results without increasing mortality.