The Role Of Delayed Lower Limb Embolectomy In Patients With Late Ischemia

BACKGROUND: Delayed presentation of acute lower limb ischemia is a challenge and controversy exists about intervention in such cases. We aim to evaluate results of delayed embolectomies concerning limb salvage and complications.METHODS: A prospective case-controlled study was carried out in the Department of vascular surgery, Qena University Hospital, on 29 patients from December 2017 to August 2018. The viability of the limb and source of thromboembolism were determined and CT angiography was done only to those presented after one week. Type of surgery, any additional surgery, amputation, its level and death were recorded.RESULTS: Twenty-nine subjects were enrolled in the study, 15 males and 14 females with a mean age of 51 years. As for comorbidities, six patients were diabetic, six patients were hypertensive, 11 had atrial fibrillation, 10 had ischemic cardiomyopathies, five had rheumatic heart disease plus mitral stenosis, and three had prosthetic valves. Two levels of occlusion were found as 20 patients presented with superficial femoral artery occlusion while nine patients presented with iliac artery occlusion. Twenty-three patients were amputation-free. No deaths were recorded in our patients related to procedure performed.CONCLUSIONS: Late revascularization markedly enhances blood flow to the limb and reduce the frequency of required amputations.