LONG-TERM RESULTS OF PERCUTANEOUS ASPIRATION EMBOLECTOMY

Purpose: To evaluate percutaneous aspiration embolectomy (PAE) as a th erapeutic alternative to surgical embolectomy. Methods: Eighty-five pa tients underwent 90 PAEs for embolic occulsions below the inguinal lig ament between October 1987 and September 1992 in a prospective study w ith a 96% follow-up. Results: The first PAE was clinically successful in 77 limbs (86%). In eight cases, major amputation was necessary. Ele ven of 13 failures were observed in limbs with acutely threatening isc hemia, but the success rate was independent of the time interval from embolism to the PAE procedure. The 30-day mortality rate was 3.5%. The cumulative primary patency rate at 1 and 4 years was 68% and 58%, res pectively. The limb salvage rate was 88% after 1 year and 86% after 4 years. The patency rate was significantly better and the mortality was significantly lower in patients receiving long-term anticoagulation w ith coumadin. Conclusion: PAE is highly effective in the treatment of embolic occulsions of the lower leg arteries and should be considered as an alternative to Fogarty balloon embolectomy.