Arterial Embolism of Limbs: Recent Experience in a Saudi Referral Vascular Unit

Abstract

Thirty-two patients with 40 acutely ischemic limbs due to arterial embolism were studied over a two-year period to define the pattern of etiologic factors and problems in management. The mean age was fifty-five years (range eight to one hundred), and the male-to-female ratio was almost 1:1. Only 8 patients (25%) presented within eight hours of onset. Lower limb ischemia occurred in 29 patients (90.6%), and the right side was affected in 16 limbs (55.2%). Large-vessel occlusion occurred in 21 patients (65.6%) and was usually treated by embolectomy. Small-vessel occlusion was encountered in 11 patients (34.4%), and embolectomy was performed in 3 of these patients (27.3%) Emboli arose from the heart in 20 cases (62.5 %) and rheumatic valvular heart disease was found in 6 patients (18.7%). Noncardiac sources were detected in 12 patients (37.5%). In 12.5 % of the cases, the author failed to determine a source. Six patients (18.7%) expired; death was associated mainly with the presence of a delayed, large embolus and myocardial ischemia. The author managed to save 22 limbs (55%). Amputation was performed on 6 limbs (15%). The author concludes that the pattern of etiologic factors of arterial embolism in Saudi Arabia is changing to one similar to that encountered in Western countries. Earlier detection and referral of cases is recommended in order to save more limbs in future.