XXXX -year experience of arterial embolectomy in a district general hospital.

@entity1 @entity262 @entity6250 @entity613 @entity955 @entity8559
We present a retrospective audit of all arterial embolectomies performed at the East Glamorgan General Hospital over @entity8559 -year period (1980-1990). Eighty-seven @entity1 (47M:40F), mean age 67 years (50-90 years) underwent 95 embolectomies, an incidence consistent with previous studies. There were 17 upper and 71 @entity6250 with a mean delay before diagnosis of 29 h (range 1-264 h). In 66% of cases the cause was @entity955 ; 33% received immediate heparinization and 14% prophylactic antibiotics. Surgery was performed by a consultant in 12 and registrars in 75 cases, and under local anaesthesia in 80% and general anaesthesia in 20%. There was no anaesthetist present in 54% of cases. Few pre- or peroperative arteriograms were performed. The 30-day mortality was 45%, with an amputation rate of 15% and an overall postoperative complication rate of 62% with little improvement in these figures over the last 10 years. Factors increasing mortality were: delay before diagnosis, grade of surgeon performing the operation, and inadequate inflow or outflow at operation. Factors found to affect limb salvage rate adversely were a history of @entity613 , although such a history was not recorded in many cases, and lack of immediate preoperative heparinization. Although embolectomy is considered a 'registrar operation', reviewing our results it can be seen that it is an uncommon operation, in our series eight or nine being performed annually. Sometimes inappropriate surgery is performed upon @entity1 in whom severe @entity262 may contraindicate any form of surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS)
