Analysis of Risk Factors for Amputation in 822 Cases with Acute Arterial Emboli

Dağ, Özgür; Kayğın, Mehmet Ali; Erkut, Bilgehan

doi:10.1100/2012/673483

Cited by 26 publications

(37 citation statements)

References 5 publications

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“…[7] The ultimate probability of an embolus reaching any specific arterial bed is determined by the relative amount of blood flow that bed receives and the anatomy of the arterial branches supplying that area. [8] Larger emboli tend to lodge at points of acute narrowing such as arterial bifurcations or areas of luminal stenosis,[69] whereas smaller emboli may travel distally to lodge in tiny arterioles. [10]…”

Section: Introductionmentioning

confidence: 99%

“…[13] The most frequent manifestations of cardiac embolic events are strokes and transient ischemic events. [5] Clots formed in the left side of the heart also account for 55-87% of emboli to peripheral arteries[91415] and most emboli to the viscera. [5] Long-term systemic anticoagulation, typically with a vitamin K antagonist such as warfarin, greatly reduces the probability of cardiac thrombus formation in high risk patients.…”

Section: Introductionmentioning

confidence: 99%

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Arterial embolism

Lyaker

Tulman

Dimitrova

et al. 2013

Int J Crit Illn Inj Sci

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Surgical and intensive care patients are at a heightened risk for arterial embolization due to pre-existing conditions such as age, hypercoagulability, cardiac abnormalities and atherosclerotic disease. Most arterial emboli are clots that originate in the heart and travel to distant vascular beds where they cause arterial occlusion, ischemia, and potentially infarction. Other emboli form on the surface of eroded arterial plaque or within its lipid core. Thromboemboli are large clots that dislodge from the surface of athesclerotic lesions and occlude distal arteries causing immediate ischemia. Atheroemboli, which originate from fracturing the lipid core tend to cause a process of organ dysfunction and systemic inflammation, termed cholesterol embolization syndrome. The presentation of arterial emboli depends on the arterial bed that is affected. The most common manifestations are strokes and acute lower limb ischemia. Less frequently, emboli target the upper extremities, mesenteric or renal arteries. Treatment involves rapid diagnosis, which may be aided by precise imaging studies and restoration of blood flow. The type of emboli, duration of presentation, and organ system affected determines the treatment course. Long-term therapy includes supportive medical care, identification of the source of embolism and prevention of additional emboli. Patients who experienced arterial embolism as a result of clots formed in the heart should be anticoagulated. Arterial emboli from atherosclerotic disease of the aorta or other large arteries should prompt treatment to reduce the risk for atherosclerotic progression, such as anti-platelet therapy and the use of statin drugs. The use of anticoagulation and surgical intervention to reduce the risk of arterial embolization from atherosclerotic lesions is still being studied.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Arterial embolism

Lyaker

Tulman

Dimitrova

et al. 2013

Int J Crit Illn Inj Sci

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“…Further analysis determined that 76 % were due to AF and valvular disease, 1.2 % due to endocarditis, 1.2 % due to cardiomyopathy and 1.5 % due to cardiac tumors [3]. On the other hand, aortic atherosclerotic plaque is another leading source of embolic disease [4].…”

Section: Discussionmentioning

confidence: 99%

Successful thrombectomy for coronary embolism likely due to floating aortic plaque in ascending aorta

Nakamura

Makino

Egami

et al. 2014

Cardiovasc Interv and Ther

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A 70-year-old man with chest pain underwent coronary intervention for acute myocardial infarction. We immediately performed coronary thrombectomy with aspiration catheter and collected solid material as a result. After aspiration, we achieved thrombolysis in myocardial infarction trial (TIMI)-flow grade 3 without stenosis. Transesophageal echocardiography showed no intracardiac thrombus but pronounced mobile aortic plaque in ascending aorta. Transthoracic echocardiography showed moderate aortic regurgitation. A histological examination of retrieved material revealed severe calcified atherosclerotic plaque without thrombotic components. Thereby, coronary embolism in this case may have been caused by embolism of flaked aortic plaque, which was possibly carried by aortic regurgitation flow.

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“…16 In the Dağ et al study, 90.1% of all amputations were in patients who underwent embolectomy 6 hours after the onset of symptoms. 17 In a study conducted by Taviloglu et al, the mortality rate could be up to 37.7% following interventions after 12 hours. 18 In addition, hemorrhagic complications could develop due to antithrombotic therapy used during the pre-operative and post-operative periods.…”

Section: Discussionmentioning

confidence: 99%

An Overlook at the Patients with Acute Lower Limb Ischemia Undergone Femoral Embolectomy

Tural¹,

Avcı²,

Altınbaş³

2017

Emerg Med Open J

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Objectives: Acute lower extremity ischemia is a rapidly progressive condition that could stem from embolism or thrombus, leading to sudden interruption of blood flow which might cause loss of limb or even mortality. In this study, the registries of the patients having acute lower limb ischemia who has previously undergone femoral embolectomy in our center were assessed, retrospectively. Additionally, relevant literature on this topic were reviewed. Materials and Methods: The data were obtained from the hospital records of 18 patients with acute lower limb arterial thrombosis ischemia who have undergone femoral artery thromboembolectomy between January 2011 and January 2017. Results: The age range of 61.1% of the patients is between 65 and 84. 1-month, 6-month, and 1-year mortality rates of the patients are 16.67%, 27.78% and 50%, respectively. A significant portion of the patients having acute lower limb ischemia has a concomitant systemic atherosclerotic disorder in the pre-operative period. High mortality and morbidity rates occur as a result of coexisting medical comorbidities of patients with acute lower limb ischemia (ALLI). Conclusion: It is crucial to take various risk factors, such as hypertension, diabetes, atrial fibrillation under control and start an immediate treatment for the prevention of multiorgan failure in the case of acute lower limb ischemia.

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Analysis of Risk Factors for Amputation in 822 Cases with Acute Arterial Emboli

Cited by 26 publications

References 5 publications

Arterial embolism

Arterial embolism

Successful thrombectomy for coronary embolism likely due to floating aortic plaque in ascending aorta

An Overlook at the Patients with Acute Lower Limb Ischemia Undergone Femoral Embolectomy

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