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Arterial emboli of the upper extremity: a persisting problem
The Journal of Cardiovascular Surgery
|May 1, 1984
Summary
Emboli of the upper extremities (UEE) often stem from cardiac disease. Prompt embolectomy within 10 hours led to good outcomes in most patients, demonstrating effective treatment for UEE.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Embolic Disease
Background:
- Emboli of the upper extremities (UEE) represent a significant clinical challenge.
- Understanding the etiology, presentation, and management outcomes of UEE is crucial for patient care.
Purpose of the Study:
- To analyze the management and outcomes of 154 cases of upper extremity emboli (UEE) over an 11-year period.
- To identify patient demographics, obstruction levels, associated conditions, and treatment strategies for UEE.
Main Methods:
- Retrospective review of 154 UEE cases managed between 1969 and 1980.
- Data collection included patient demographics, obstruction site, cardiac disease prevalence, ischemia severity, treatment modalities, and outcomes.
Main Results:
- 151 patients (66% female, mean age 68.9) experienced 154 UEE, predominantly affecting the brachial artery (74 cases).
- Cardiac disease was a common comorbidity (119 cases). Severe ischemia occurred in 30% of cases.
- 106 patients underwent surgery within 10 hours, with 140 primary embolectomies being the main treatment. Reoperation was infrequent (7%).
Conclusions:
- Prompt surgical intervention, primarily embolectomy, yields favorable results in managing upper extremity emboli.
- Cardiac disease is a major underlying factor, necessitating comprehensive patient evaluation.
- Effective management of UEE leads to clinical improvement and restoration of arterial patency in the majority of patients.