[Acute arterial occlusion of the lower extremities]

The clinical course of 40 patients with acute arterial occlusions of a lower extremity was reviewed with special reference to the etiology. Patients were classified into three groups: arterial embolism (10 patients), acute atherosclerotic thrombosis (AAT) (13 patients), and miscellaneous (17 patients). Circulation was restored in 83% of cases; embolism, 100%; AAT, 55%; and miscellaneous 88%. Five patients (13%) died, including 2 of MNMS (Myo-nephropathic-metabolic syndrome). MNMS developed in 1 patient in the embolism, 2 patients in the AAT, and 5 patients in the miscellaneous group. The five patients with MNMS in the embolism and miscellaneous groups were treated between 6 to 12 hours following the onset of symptoms, while both patients in the AAT group were not treated until 24 to 72 hours following occlusion. Revascularization was successful in the AAT group even when the ischemia lasted for 6 to 8 hours. However, patients in the embolism and miscellaneous Groups, who lacked effective collateral circulation, were at greater risk for developing MNMS when ischemia last for more than 6 hours.