Femoral Embolectomy for Embolic Lower Limb Ischemia: Influence of Coexisting Atherosclerotic Occlusive Disease

Abstract

The authors studied the results after embolectomy performed in patients admitted with a diagnosis of acute embolic lower limb ischemia. All patients had a potential cardiac source of emboli. The results were retrospectively analyzed in two groups of patients: those with and those without atherosclerotic occlusive disease in the femoral artery. Gangrene was uncommon and the mortal ity rate was low (10%) in patients without occlusive disease, whereas postopera tive gangrene with or without death of the patient was common (37%) and the mortality rate was high (34%) in patients with occlusive disease. Embolectomy performed within twelve hours from onset of symptoms was more often success ful than embolectomy performed later in patients without, but not in those with, occlusive disease. Reoperations, as well as bleeding complications in anticoagu lated patients, were more frequent in the latter patients. This study indicates that patients with peripheral atherosclerotic occlusive disease constitute a signif icant risk group for morbidity and mortality after embolectomy. It is suggested that occlusive disease should be actively searched for when a patient with acute lower limb ischemia is admitted and also when the acute ischemia is judged on clinical grounds to be of embolic origin.