Emergency Embolectomy for Acute Vascular Occlusion in Al Sader Teaching Hospital /Al-Basrah City
Abstract
Background Embolectomy can be consider a simple procedure that can be performs underlocal anesthesia which have a great influence on the outcome of patients and their limbs
,especially when it performs within the golden hours of ischemia.
Aim of Study This study was designed to discuss the effectiveness of embolectomy procedure
in the management of acute vascular occlusion in our center and compare the outcomes with
other regional and national studies.
Patients And Methods A retrospective study was carried out from October 2014 to October
2017 at AL Sadder teaching hospital in Al Basrah city. Traumatic vascular occlusions were
excluded from this study. The collected data was reviewed retrospectively including age, sex,
associated, comorbidities, time before initial symptoms and outcome after embolectomy.
Results Ninety seven patients were admitted to the vascular ward with signs and symptoms of
ALI. The mean age was 56 years, 51.5% female and 48.5% male. All of them underwent
emergency embolectomy. The cause of vascular occlusion was embolism in 72 patients and
thrombosis in 12 patients. The limb salvage rate was 88.65%, Eleven patients ended with limb
amputation. Complication occurred in 31 patients in the form of: ten patients hematoma, nine
patients SSR, five patients re embolectomy, four patients fasciotomy, two patients foot drop
and one patient AKI. Thirteen patients died with hospital mortality rate of 13.4%. There was
a significant correlation between the time from the initial symptoms to the surgical
intervention and limb amputation rate (P value = 0.0009).
Conclusions Embolectomy is an important procedure in the management of patients with
ALI with a high limb salvage rate up to 88%. Time interval between the initial symptoms of
vascular occlusion and surgical intervention is an important predictor to the limb’s outcome
after embolectomy; the earlier the treatment the better the results.
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