The Fogarty arterial embolectomy catheter, while indispensible in the armamentarium of the vascular surgeon, is not entirely benign instrument. A case is desribed in which the balloon was lost in its entirety from the catheter and immediately retrieved using a second identical instrument. A comprehensive survey of the literature reveals that a variety of arterial injuries have occurred during the use of the Fogarty catheter. Each of the major ones is discussed in depth. Amongst the most serious are arterial perforation and rupture occasionally followed by loss of the involved extremity. All previously reported complications following use of the Fogarty catheter are tabulated and reviewed. Additionally, a formal classification of these complications is proposed. Since the time of its introduction in 1963 the Fogarty ballon-tipped catheter has become an indispensible tool in the armamentarium of the vascular surgeon. Its use for arterial embolectomy has been responsible for the salvage of many thousands of limbs. Over the course of the past decade, however, a number of complications referable to this instrument have appeared in the literature. These include perforation of vessels, intimal disruption and foreign body embolization amongst others. To our knowledge, however, there has been only one reported case of a balloon having been lost intra-arterially in toto without obvious cause. It is the purpose of this paper to present the second such case where the balloon, which had separated entirely from the catheter during the course of an arterial embolectomy, was later retrieved by passage of a second Fogarty catheter. In addition, a comprehensive review of the literature is undertaken, and all arterial complications reported to date summarized and tabulated.

Laboratory studies showed the urinalysis and blood count to be within normal limits. The electrocardiogram showed n.o"ab< normalities. X-ray examination of the abdomen revealed obstruc¬ tion low in the small intestine, with no evidence of distention of the colon. Because of the numerous previous operations that made likely the diagnosis of obstruction due to adhesions, be¬ cause the obstruction did not seem to be complete, and because of the normal vital signs and blood count, a trial of nonoperative management was undertaken. A Miller-Abbott tube was passed, parenteral fluids were administered, and the patient was care¬ fully observed.

During the past 25 years, great progress has been made in saving patients with serious cardiac injuries. This study is based on nine consecutive cases of penetrating wounds to the heart treated successfully by surgical intervention at a community hospital with no facilities for cardiopulmonary bypass. Early surgery is advocated for patients suspected of having penetrating injury of the heart.

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