Jarrett F, Dacumos G C, Crummy A B, Detmer D E, Belzer F O
Surgery. 1979 Dec;86(6):898-905.
Although the occurrence of an arterial embolus is usually a cataclysmic event prompting emergency presentationand early diagnosis, we have managed 22 patients who presented more than 48 hours after the onset of symptoms. The diagnosis was apparent in only six patients. The remainder had subacute limb ischemia, and arteriography was used to help delineate the diagnosis in 14 of these patients. In most instances arteriograms were atypical of chronic occlusive disease, rather than diagnostic of arterial emboli. Embolectomy was performed a mean of 13 days after the onset of symptoms, with retrieval of thromboembolic material in all instances. Two patients died (mortality rate of 9%), and the limb salvage rate for the 25 limbs explored was 88%. Among 22 lower extremity embolectomies, foot pulses were restored in 13 patients (59%), and four patients (18%) had viable extremities without pulses. Adjunctive arterial reconstruction was required in three patients.
尽管动脉栓塞的发生通常是一个引发紧急就诊和早期诊断的灾难性事件，但我们已经处理了22例在症状出现48小时后就诊的患者。只有6例患者的诊断很明显。其余患者有亚急性肢体缺血，其中14例患者通过动脉造影来辅助明确诊断。在大多数情况下，动脉造影表现并非典型的慢性闭塞性疾病，而不是诊断为动脉栓塞。平均在症状出现13天后进行了栓子切除术，所有病例均取出了血栓栓塞物质。2例患者死亡（死亡率为9%），在接受探查的25条肢体中，肢体挽救率为88%。在22例下肢栓子切除术中，13例患者（59%）恢复了足部脉搏，4例患者（18%）肢体存活但无脉搏。3例患者需要进行辅助性动脉重建。
