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Arterial embolectomy in lower limbs

N Wolosker1, S Kuzniec, A Gaudêncio

  • 1General Hospital of the College of Medicine of the University of São Paulo, Brazil.

Sao Paulo Medical Journal = Revista Paulista De Medicina
|July 1, 1996
PubMed
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Lower limb arterial embolisms are common. Embolectomy with the Fogarty catheter effectively preserves limbs, especially when ischemia is less than 24 hours and patients are in good condition.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine
  • Emergency Medicine

Background:

  • Arterial embolisms in the lower limbs are a frequent and significant concern for vascular surgeons.
  • Atrial fibrillation is the primary cause (78%) of lower limb arterial embolisms.

Purpose of the Study:

  • To evaluate the outcomes of lower limb embolectomy using the Fogarty catheter in patients with arterial embolisms.
  • To identify factors influencing limb preservation and complication rates.

Main Methods:

  • A retrospective study of 159 patients with lower limb arterial embolisms between January 1991 and July 1993.
  • All patients underwent lower limb embolectomy with the Fogarty catheter, primarily via the femoral artery.
  • Data on patient demographics, etiology, occlusion site, ischemia duration, surgical procedures, and outcomes were analyzed.

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Main Results:

  • The femoral artery was the most frequent site of occlusion (53.4%).
  • Most patients (67.9%) had ischemia duration less than 24 hours.
  • Limb preservation was achieved in 84.6% of operated limbs (127/150).
  • Factors associated with worse outcomes included muscle tenderness, paralysis, or ischemia lasting longer than 24 hours (p < 0.05).
  • Mortality was 10.7% (19/159), primarily due to heart failure (68.4% of deaths).
  • Amputation was required in 16.4% of surviving patients (23/140).

Conclusions:

  • Embolectomy with the Fogarty catheter is an effective treatment for lower limb arterial embolisms, leading to high rates of limb preservation.
  • Patients presenting in good clinical condition without limb necrosis and with ischemia duration under 24 hours experience better outcomes.
  • Early intervention and favorable patient condition are critical for successful limb salvage and minimizing complications.