We present a retrospective analysis of arterial embolectomies performed at the Inje university Seoul Paik Hospital. During the period of March 1987 - Feburary 1996 twenty-six patients underwent embolectomies, eighteen patients were male and eight
patients were female, mean age of patients was 56.8 years. Rest pain was the chief complaint in 24 patients, the remaining two patients complained of long term history of claudication after recovery of acute symtoms. But only 10 patients had
sensory/motor symtoms. Heart was the most common source of embolization and frequent predisposing factor of embolism was ischemic heart disease in 8 cases and valvular heart disease in 11 cases. The sites of embolization were upper extremities
artery in
6 cases, saddle embolism in 2 cases, lower extremities artery in 18 cases and the most common site of embolism was femoral artery in 11 cases. Preoperative angiography was taken in the diagnosis and planning of the embolectomy in 13 patients
while
in
the other patient preoperative angiography was not taken. Only two cases were operated within the golden period of 6 hours and other cases were operated in more than 6 hours after embolization. In all patient, the Fogarty embolectomy catheter was
used
without bypass surgery via bachial ateriotomy in the embolism of upper extremities artery, bilateral groin approaches in the saddle embolism and transfemoral approach in the embolism of lower extremities artery. However 3 patients were
re-operated
via
transfemoral approach in the distal poplitiotibial embolism. Eighteen patients received perioperative anticoagulation therapy by heparin or fraxiparine and wafarin was used in 17 patients at the time of discharge and the indication of
anticogulation was
patients of valvular heat disease and/or atrial fibrillation, peripheral artery atherosclerosis and recurrent embolism. Postoperative results of the embolectomy were as follows: fouteen pateints had excellent results, five cases had symtom
improvement
after re-operation, B. K. amputation in 1 cases who had severe atherosclerosis of lower extremities, recurrent embolism in 1 case and death in 2 cases the cause of death were acute renal failure and cerebral artery embolism, respectively. The
complications of the embolectomy were reperfusion syndrome, pseudoaneurysm and intimal dissection in one case each. Conclusively the problems of embolism is delayed diagnosis and increasing umber of old aged patient who had suffered from ischemic
heart
diease. Preoperative angiography was not always need for embol ectomy. Selective anticoagulation therapy can decrease incidence of re-embolism. In the distal poplitiotibial embolism, seletive embolectomy of tibial artery was difficult.
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