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Cardiogenic embolism of the upper extremity
The Journal of Cardiovascular Surgery
|May 1, 1982
Summary
Arterial embolism of the upper extremity can lead to severe ischemia or gangrene. Prompt diagnosis and treatment, including balloon catheter embolectomy, improve outcomes, though mortality is linked to underlying heart conditions.
Area of Science:
- Vascular Surgery
- Emergency Medicine
- Cardiology
Background:
- Arterial embolism of the upper extremity is more common and less benign than previously thought.
- Significant rates of postembolic ischemic changes or gangrene can affect the hand and fingers.
Purpose of the Study:
- To update current concepts regarding upper extremity arterial embolism.
- To review clinical data and methods for assessing hand/forearm viability.
- To evaluate the effectiveness of arterial embolectomy.
Main Methods:
- Review of clinical data and viability assessment techniques.
- Liberal use of arteriography for diagnosis.
- Balloon catheter arterial embolectomy, often under local anesthesia.
Main Results:
- Complete circulatory restoration in 55% of patients.
- Salvage without return of wrist pulses in 24%.
- Gangrene occurred in 9.3% and mortality in 11.8%.
Conclusions:
- Balloon catheter embolectomy is a simple, safe, and effective treatment for upper extremity arterial embolism.
- Mortality is primarily associated with underlying cardiopathy, not the embolectomy procedure itself.
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