Acute ischemia of the upper extremity: long-term results following thrombembolectomy with the Fogarty catheter

Objective: In 1962, the procedure of arterial thrombembolectomy with the Fo garty catheter was established. Numerous studies have been published studyi ng thrombembolectomies of the lower extremities. Limited information, howev er, is available following thrombembolectomy of the upper extremity after a rterial occlusion. The aim of the present study, therefore, was to determin e long-term results (3-5 years after thrombembolectomy) following thrombemb olectomy of the upper extremity with the Fogarty catheter in a large retros pective clinical study. Design: In the present study, 251 patients were enc ountered. Over a period of 20 years, 283 thrombembolectomies with the Fogar ty catheter were performed on the upper extremity at the surgical departmen t of the University of Munich. Main outcome measurements: The appearance of local and general complications in the postoperative phase, as well as lon g-term results, were evaluated. Results: The results indicate that general complications i.e., cardiac insufficiency, cerebral ischemia, etc.-occurred in 18 patients (7.2%). Local complications-i.e., wound infection, persiste nce of ischemia, or hematoma-were evident in 51 patients (20.3%). Re-occlus ion following thrombembolectomy was found in 21 patients (8.8%). The affect ed extremity had to be amputated in five cases (2.0%), and 14 patients (5.6 %) died during the postoperative phase. As a result of multimorbidity of th e patients and average age at the time of surgery (73 years), 40% of the pa tients had died before the date of examination. Nonetheless, 111 patients o f the 117 living patients showed no complaints or minor coldness and pain f ollowing heavy exercise. Conclusions: The results of the present study indi cate that, in most cases, thrombembolectomy with the Fogarty catheter repre sents a successful surgical method for the acute treatment of arterial occl usion of the upper extremity.