Embolism of the popliteal artery

The experience with popliteal arterial embolism at the Massachusetts General Hospital was surveyed, and the results of therapy prior and after the introduction of the balloon-tipped embolectomy catheter were compared. During the 17 year period from January of 1964 to January 1981, 67 popliteal emboli were diagnosed. Nonsurgical management was successful in salvaging 11 of 13 extremities in ten patients with one death. Surgical embolectomy was performed upon 54 extremities in 48 patients with 40 limbs salvaged and 11 deaths. Although the percentage of patients undergoing surgical therapy for popliteal emboli has dramatically increased since the introduction of embolectomy catheters, no improvement in limb salvage or in patient survival has resulted. In fact, the limb salvage rate has declined. Nonsurgical management in appropriately chosen patients is clearly successful. The results of this survey emphasize the necessity of early diagnosis and treatment as well as selective patient management. Recommendations for a therapeutic approach to popliteal emboli are presented which hopefully will improve the results.