Clinical Features of Lower Extremity Artery Embolism: Comparison of the Clinical Features between Ilio-femoral and Popliteal Artery Embolism

Kim, Keun Young; Kim, Seung Ho; Byun, Seung Jae; Kwon, Jung Nam; So, Byung Jun

Abstract

PURPOSE: Prompt operative management of patients with peripheral artery embolism remains the treatment of choice for this malady. The clinical status of the limb, rather than the elapsed time from the onset of occlusion, was recently determined to be the best predictor of limb salvage. We investigated the clinical features, therapeutic modalities and treatment results of popliteal artery embolism compared with that of ilio-femoral artery embolism.
METHODS
A retrospective review was carried out for 21 cases that were treated for lower extremity arterial embolism, from March 2000 to June 2006. The patients were classified into two groups; Group A (ilio-femoral artery embolism, n=11) and Group B (popliteal artery embolism, n=10). We analyzed the interval time from the onset of symptoms to starting treatment (the interval time), the degree of limb ischemia, the therapeutic modalities and the treatment results.
RESULTS
The average interval time was 16.2+/-16.9 hours in the total 21 cases; the average interval time for Group A was 7.7+/-2.9 hours and that for Group B was 25.5+/-20.9 hours (P<0.05), and the incidence of severe limb ischemia (class IIb according to the SVS/ISCVS reporting standard) was 72.7% vs 20.0%, respectively (P<0.05). For the therapeutic modalities, surgical thromboembolectomy was performed in all cases of Group A and for 3 cases of Group B. Seven cases of Group B received radiologic intervention (3 cases percutaneous aspiration embolectomy only, and 4 cases of additional thrombolytic therapy).
CONCLUSION
This study shows that the interval time for popliteal artery embolism is longer than that for ilio-femoral artery embolism. In other words, it is suggested that the symptomatic progression of popliteal artery embolism is slower than that of ilio-femoral artery embolism. Therefore, we can have more chances for variable therapeutic options such as surgical thromboembolectomy, percutaneous aspiration embolectomy and/or thrombolytic therapy in patients suffering with popliteal artery embolism.