EMBOLECTOMY FOR ACUTE LIMB ISCHEMIA: EXPERIENCE IN 84 CASES IN A TERTIARY CARE HOSPITAL

Embolectomy

Abstract

Objective: To highlight the presentation, outcome and the role of embolectomy in the management of acute limb ischemia.
Study design: A descriptive study.
Place and Duration of study: Department of Vascular Surgery, CMH Rawalpindi from Oct 2008 to Dec 2010.
Patients and Methods: All patients with acute limb ischemia presenting at CMH Rawalpindi during study period and managed by embolectomy were included. Embolectomy was performed through transfemoral or transbrachial approach, depending upon the limb involved under local anesthesia with Fogarty catheter.
Results: Eight four patients of acute limb ischemia were managed by embolectomy during study period. Lower limb was affected more frequently 51 (60.7%) than upper limb 33 (39.3%). Male to female ratio was 1.4: 1. Forty eight (57.1%) patients reported 12 hours after the onset of symptoms. Embolism was the most common cause present in 53 (63%) and most frequent site of obstruction was femoral bifurcation 23 (45%). Presence of paralysis and skin changes were bad prognostic signs. Eight patients (9.5%) had fasciotomy at the time of embolectomy. Nine major amputations were carried out in 8 patients (10.7%). Eleven patients (13.0%) died within 30 days. Limb salvage rate was 83.3%.
Conclusion: In the scenario of multiple new therapeutic techniques, embolectomy is still a simple, safe and effective surgical option for treatment of acute limb ischemia.