LIMB ISCHEMIA - SURGICAL THERAPY IN ACUTE ARTERIAL-OCCLUSION

Mortality and amputation rates from acute arterial occlusion are repor ted from 7 to 37 per cent and 10 to 30 per cent, respectively. Recent data from thrombolysis or peripheral arterial surgery suggest no signi ficant differences between initial management with surgical or thrombo lytic therapy. Mortality and amputation rates were in the above ranges . The last 230 procedures (216 patients) over 10 years were reviewed. All graft occlusions, cardiac catheterization injuries, and aortic bal loon-related thromboses were excluded. Immediate and delayed amputatio n rates were 6.5 and 0.9 per tent. Death. occurred in 21 patients (9.7 %), with only 6 deaths over the last 6 years (3.8%). Except for transe sophageal echocardiography, perioperative studies were of limited valu e. Long-term anticoagulation was also not effective in preventing recu rrent episodes, A mortality rate of 9.7 per cent and amputation rate o f 7.4 per cent justifies an early aggressive surgical approach. Limite d perioperative studies and less prolonged anticoagulation may also im prove cost containment.