Artery embolism of the upper limbs

Area of Science:

• Vascular Surgery
• Cardiovascular Diseases
• Ischemia Management

Background:

• Arterial emboli to the upper limbs are a significant clinical challenge.
• Cardiac diseases are the primary etiology, accounting for over 90% of cases.
• Limb ischemia severity ranges from mild to acute, impacting function and potentially leading to contractures.

Purpose of the Study:

• To analyze outcomes of treating arterial emboli in the upper limbs.
• To evaluate different surgical approaches and their effectiveness.
• To identify optimal treatment strategies for improved circulation restoration.

Main Methods:

• Retrospective analysis of 260 arterial emboli cases in upper limbs over 35 years (1939-1974).
• Comparison of conservative treatment, arteriectomy, and embolectomy.
• Evaluation of embolectomy outcomes based on surgical approach (cubital fossa vs. antecubital) and use of Fogarty catheter.

Main Results:

• Embolectomy, particularly with the antecubital approach and Fogarty catheter, achieved 91.59% full circulation restoration.
• Severe and acute ischemia were prevalent, affecting patient mobility and function.
• Overall hospital mortality was 21.1%, with recurrent embolism and post-ischemic complications as main causes of death.

Conclusions:

• The antecubital approach using a Fogarty catheter is the preferred method for embolectomy in upper limb arterial emboli.
• Prompt and effective surgical intervention is crucial to prevent severe ischemia and improve limb salvage.
• Understanding the causes of mortality is vital for refining patient management and reducing fatal outcomes.