Daniela RADU  Chief Editor

Surgical Treatment in Acute Embolic Ischemias

When presented with an acute ischemia of the inferior limbs this might be due to an emboly or to an acute thrombosis. The differenciation between the two types of arterial occlusion is very important for the terapeutic decision, as in the embolic occlusion an emergency embolectomy is necessary while in the thrombotic occlusion the method of choise is surgical revascularisation.

Analysing the patients of The Surgical Clinic I from Timisoara in a period of 10 years there were 34 patients with arterial embolies, wich represents 32% of the cases of acute ischemia. The rest of 68% (72 patients) had acute thrombosis due to arterosclerotic arteriopathies, either diabethical or thrombangeitical. The source of the embolies was in most cases the left heart:

1. mitral valvulopathies-17 cases,

2. ischemic cardiopathies with atrial fibrillation, aortic insufficiency from heart infraction, in other 17 cases.

The emboles were fixed at:

1. aorta bifurcation-7 cases,

2. iliac artey-11 cases,

3. femoral artery-11 cases,

4. popliteal artery-3 cases,

5. humeral artery-2 cases,

6. leg arteries-2 cases

The terapeutic procedures used in the acute embolic ischemias were:

1. embolectomy-21 cases,

2. medical treatment-4 cases,

3. amputation-9 cases

Conclusion
Due to the gravity of acute embolic ischemia the correct diagnosis is an imperious necessity as well as the emergency surgical treatment together with an impeccable technique are the factors that can save the affected extremity. If one of these factors are missing, the emergency amputation remains unfortunately, the only procedure that can save the patients life.