J.Jpn. Surg. Soc.. 82(9): 999-1003, 1981

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Report on the annual meeting

SURGICAL TREATMENT OF ACUTE ARTERIAL OCCLUSION OF EXTREMITIES

One hundred forty three patients of acute arterial occlusion of extremities were studied. Arterial embolism were in 66 patients, in whom 40 derived from mitral stenosis, 20 from ischemic heart disease and another 6 patients were aneurysm, myxoma of left atrium and left atrial infiltration of lung cancer. Their mortality rates were 10%, 50% and 50%, respectively.
Arterial thrombosis was observed in 31 patients, in whom 18 patients were caused by arteriosclerosis and another 13 patients were traumatic thrombosis and etc. Their mortality rates were 38.9% and 8%. Ampμtation rates were 33.3% and 8%, respectively.
Iatrogenic arterial occlusion were observed in 46 patients and there were no death.
In general, all the cases with acute arterial occuusion of extremities should be thromboembolectomized by using Fogarty catheter as soon as possible after onset of the symptoms. Surgery for poor risk patients should be performed under local anesthesia.
Surgical treatment of basic disease and anticoagulant therapy was necessary to pervent reccurent arterial occlusion.
For life saving, amputation of extremities should be performed without any hesitation.
Compared to adult patients, there were higher incidence of iatrogenic arterial occlusion in cases under 6 years old after percutaneous arterial catheterization. In such cases, when arterial occlusions were not treated properly, growth of extremities were deteriorated, and arterial reconstruction should be performed as soon as possible after onset of symtoms.

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