Acute arterial embolism of the lower extremities: impact of 24-hour duration on the outcome of management
Mutirangura, P.; Ruangsetakit, C.; Wongwanit, C.; Sermsathanasawadi, N.; Chinsakchai, K.
Journal of the Medical Association of Thailand 91(9): 1360-1367
2008
ISSN/ISBN: 0125-2208 PMID: 18843865 Document Number: 10760
Determine the impact of 24-hour duration of arterial embolism on the outcomes of management. A prospective study of 91 patients with acute arterial embolism of the lower extremities was carried out. Among the 91 patients, 31(34.1%) were with early acute embolism(< 24 hours) and 60 (65.9%) were with late acute embolism (> 24 hours). Extensive limb gangrene was more common in patients with late acute embolism (26.7% versus 3.2%, p = 0.009). Subsequently, primary major amputation was higher in those patients (20% versus 3.2%, p = 0.05). In early acute embolism, surgical embolectomy was only the primary treatment of revascularization (87.1%) whereas in late acute embolism, there were varying modalities of revascularization (68.3%) in addition to surgical embolectomy. The successful revascularization after the initial surgical embolectomy was significantly higher in patients with early acute embolism (92.6% versus 43.9%, p < 0.001). Patients with late acute embolism had a higher tendency of undergoing major amputation after revascularization (24.4% versus 7.4%, p = 0.106). Successful outcome was higher in patients with early acute embolism (83.9% versus 58.3%, p = 0.014). The 24- hour duration of arterial embolism may be a crucial factor influencing the outcome in the management of this disease.
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