Late Arterial Embolectomy

Abstract

Cases (11) of late embolectomy are described. These patients were operated on 13 h to 20 days after onset of acute arterial embolism in the lower limbs. The mean time of intervention was 6.48 days. The average age of the patients was 61.8 yr, the youngest being 44 and the oldest 71. The arteries affected were the iliac in 1 patient, the femoral in 7, and the popliteal in 3. The results were revascularization in 4 patients, amputation in 5 and death in 2. The direct arteriotomy technique, combined with use of a Fogarty balloon catheter, yields the best results. Failures were mainly due to incomplete removal of the emboli, especially in the arteries distal to the arteriotomy and selection of patients whose limbs were not viable. Smoothness of the muscle mass in the lower limb is the best criterion to determine viability.