[Indications and results of thrombo-embolectomy in acute ischemia of the extremities].

A personal series of 176 thrombo-embolisms in the extremities, 157 of them operated, observed at the Surgical Clinic of Cagliari University in the period 1969-1977, is reported. The results of surgery are discussed in relation to the factors which most affect prognosis: age, time and degree of ischaemia, anatomo-pathological condition of the arteries and site of obstruction. Severe ischaemia poses the problem of indication for disobstruction: the possible onset of the revascularization syndrome, which almost always causes the death of the patient, should be borne in mind. Recently proposed local wash-out techniques do not complete solve the problem because although they manage to prevent the revascularization syndrome, they do not always save the extremity, which has to be amputated at a later stage after pointless risks to the patient. On the other hand, the poor functional results obtainable from an extremity that has suffered severe ischaemia must be considered. It is therefore preferred to forgo disobstruction when the ischaemia is so serious that revascularization syndrome is probable.