Acute thrombosis and embolism of the extremities: Factors influencing the result of treatment

Eighty-five cases treated for acute nontraumatic ischemia of the extremities have been reviewed. Eighty per cent were diagnosed as emboli and the remaining 20% were considered to have acute thrombosis. The most common embolism source was the heart and the most common heart disease causing embolism was atrial fibrillation. Seventy patients were treated surgically (80 surgical procedures) and 14 conservatively. All surgical patients received pre-, per- and postoperative anticoagulants. Limb-salvage rate was 76% in patients with emboli and 60% in the thrombosis group. The amputation rate was significantly higher in the thrombosis group. The overall mortality was 12% and was slightly but not significantly higher in the embolism group. It is concluded that acute arterial emboli should be treated rapidly by embolectomy. Acute thromboses carry a higher amputation rate if treated by thrombectomy alone and thus reconstruction should be considered. The relatively low mortality rate in the present material could be due to the routine use of anticoagulants.