Arterial embolectomy: a 34-year experience with 400 cases.

Area of Science:

• Vascular Surgery
• Cardiovascular Medicine

Background:

• Peripheral arterial emboli are a significant cause of limb-threatening ischemia.
• Cardiac disease is a primary etiology for embolic events.

Purpose of the Study:

• To evaluate the long-term outcomes of peripheral arterial embolectomy.
• To identify factors influencing mortality and amputation rates.

Main Methods:

• Retrospective analysis of 400 peripheral arterial embolectomies in 326 patients over 34 years.
• Inclusion of data on operative mortality, amputation rates, and limb salvage.
• Assessment of embolic source, location, and time to intervention.

Main Results:

• Overall operative mortality was 11.0%, decreasing slightly to 10.0% after Fogarty catheter introduction.
• Amputation rate was 9.5%, resulting in a 90.5% limb salvage rate.
• Higher mortality associated with cardiac disease, aortic/iliac emboli, and recent myocardial infarction.
• Increased amputation rates linked to femoral/popliteal emboli and delayed treatment.

Conclusions:

• Prompt surgical management of peripheral arterial emboli is the preferred treatment.
• Early embolectomy and routine heparin administration contribute to low mortality and amputation rates.
• Underlying cardiac disease remains a major determinant of mortality.