ABSTRACT
A retrospective review examined patients treated with surgical embolectomy for acute limb ischemia. It is believed that thrombolytic therapy allows for enhanced clearance of thrombus from vessels too small for traditional embolectomy catheters and can diagnose underlying pathology. There was no demonstrable difference between limbs treated for thrombotic etiology versus embolic etiology. The major conclusion is a decreased need for open surgical revascularization and a reduced magnitude of the surgery. Intraarterial endovascular techniques as initial therapy for acute limb ischemia appear to be in equipoise relative to open surgical treatment for achieving limb salvage and may reduce mortality. Unfortunately, there is little high-quality data to guide our treatment of acute arterial embolus. While it is often possible to distinguish between embolic versus thrombotic etiologies based on history and examination, the error rate remains as high as 25%.
