Acute Arterial Embolus

Between December, 1983, and December, 1988, 100 patients (54 men, 46 women) with acute arterial embolus, ranging in age from twenty-three to eighty-three years, were treated in our clinics. The main symptom of the patients was pain (94%), followed by coldness (72%), pallor (64%), sensory defect (42%), motor disorder (37%), muscular rigidity (10%), and tissue necrosis (7%). We have determined the etiology to be atrial fibrillation in 53 cases, 36 of which arose from mitral stenosis: acute myocardial infarction (MI) in 14 cases; thromboembolus based on arteriosclerosis obliterans (ASO) in 27 cases; and tumor embolus in 2 cases; 4 cases could not be explained etiologically. The most common site of embolism was the femoral artery (33%). Arterial exploration was done under local anesthesia in the 76 patients who did not have distal localization of the embolus. Embolectomy was performed in 49 of these cases and embolectomy plus localized tromboendarterectomy in 27. Owing to developing necrosis, amputation was necessary in 6 cases-4 above the knee and 2 above the elbow. Motor and sensory defect persisted to various degrees in 27 cases. The death rate was 4%.