Clinical Review of Acute Arterial Occlusive Disease in Lower Extremities

Park, Won Cheol; Lee, Kyoung Keun; Chae, Kwon Mook; Roh, Byung Suk; So, Byung Jun

Abstract

Despite various methods of treating acute lower limb ischemia, the reported mortality continues to be in the 10% to 30% range. To evaluate the results according to etiology, location, time interval before starting treatment of acute lower extremities occlusive lesion, this study was done for 38 patients with acute arterial occlusive disease. The causes of acute lower limb occlusion were embolism (n=18, 47.4%) and thrombosis (n=20, 52.6%). The mortality rate was 11.1% (2/18) in embolism and 10% (2/20) in thrombosis. All the patients with embolic occlusion were treated by thromboembolectomy with Fogarty catheter, and thrombotic occlusive lesion were treated by intraarterial thrombolytic therapy only (n=3), followed by corrective procedure such as PTA only for short iliac arterial lesion (n=1), PTA and stent for long iliac arterial lesion (n=5), bypass operation (n=5). The amputation rate was higher (p,<0.05) in thrombotic group (6/20, 30%) than in embolic group (2/18, 11.1%), in longer duration group (>24 hr, 7/20, 35.0%) than in shorter duration (<24 hr, 1/18, 5.6%), and in multiple lesion (7/13, 53.7%) than single lesion (1/25, 10.0%). Even though advanced therapeutic modality for acute lower limb occlusive disease, mortality is still high, and limb salvage is dependent on various factors such as status of patients, etiology and number of lesion site, time interval before starting treatment.