[Clinical aspects and treatment of acute arterial occlusion].

163 patients underwent surgery for acute ischemia of the lower extremity between 1982 and 1986. Thrombosis was present in 50 cases and embolism in 113. Half of the patients with thrombosis showed signs of chronic occlusive disease of the arteries (intermittent claudication); in the latter group 2/3 of the patients had atrial fibrillation and 1/4 coronary heart disease. For embolism Fogarty-catheter clot extraction was performed, mainly under local anesthesia. This procedure is easy to perform even under emergency conditions (mortality 10%, amputation rate 8%). In contrast, the surgical procedure in thrombotic occlusion was more demanding (mortality 4%, amputation rate 16%) and in the case of severe ischemia had to be carried out on an emergency basis. In case of less severe ischemia the treatment consisted in initial heparinization and elective revascularization when the patient was stabilized. A new therapeutic approach involving local catheter thrombolysis, catheter clot aspiration and balloon dilatation is presented. The combined catheter intervention produces good results in 70% of patients, particularly those with femoral thrombosis.