Continuous heparin anticoagulation in patients with arteriosclerosis and arterial emboli

Management of arterial emboli occurring in patients having generalized arteriosclerosis presents a therapeutic challenge to the vascular surgeon. Adequate cardiac function must be vigorously supported. Perioperative metabolic alterations must be recognized and corrected. Continuous anticoagulation with heparin sodium appears indicated among such patients with coexisting peripheral arterial occlusive disease, stasis, poor collateral flow and areas of intimal damage secondary to operative trauma. Rarity of wound complications, less than 5 per cent, may be attributed to meticulous operative technique and use of continuous infusion method for the administration of heparin. Improved patient survival and limb salvage rates may be attributed, in part, to continuing heparin therapy in the postoperative period and appears justified among those with arteriosclerosis.