Abstract
Two hundred patients (103 men, 97 women, average age sixty-three years) with acute arterial occlusion of the vessels of the arm (AAOVA) were treated surgically in the period from January, 1985, to May, 1991; 70.5% of the occlusions were due to emboli and 29.5% were due to primary thrombosis. The subclavian/axillary arteries were occluded in 29% of the cases, the brachial artery in 59%, and the radial/ulnar arteries in 12%; 77.6% of the subclavian/axillary obstructions were due to emboli and 22.4 to thrombosis, 72.9% of the brachial obstructions were due to emboli and 27.1% to thrombosis, and 41.7% of the radial/ulnar obstructions were due to emboli and 58.3% to thrombosis.
Local anesthesia was employed for all patients. There were 49 reoperations: 27 for rethrombosis, 8 for reembolization, 9 for evacuation of hematomas or control of hemorrhage, and 5 for treatment of infection; 11 fasciotomies were performed. Ten (5%) of the patients died, primarily because of cardiac failure or strokes. In 169 patients (84.5%) one or both distal pulses were restored at the wrist with return of normal extremity function. In 22 patients (11%), distal pulses were not restored but the clinical results were satisfactory. In 9 patients (4.5%), amputation at various levels was necessary owing to delayed presentation for treatment, extended thrombosis, or poor vascular status.
Get full access to this article
View all access options for this article.