• Afzal Siddique CMH Rawalpindi
  • Nauman Imtiaz CMH Rawalpindi.
  • Khalid Pervaiz CMH Rawalpindi
  • Kishwar Ali CMH Rawalpindi
  • Rai Ahmad CMH Rawalpindi
  • Fazal-e Haider CMH Rawalpindi


Background: The aim of this study is to share our experience regarding outcome of embolectomy in the patients presenting late with acute limb ischemia. It was a cross sectional descriptive study, conducted at CMH Rawalpindi from January 2016 to December 2017. Methods: All those patients having non-traumatic acute limb ischemia presenting between 6 to 72 hours of the onset of symptoms with viable affected limb were included. Their data was analysed for demography, involved limb, time of embolectomy, fasciotomy, re embolectomy, amputations, reperfusion injuries and death. The patients presenting later than 72 hours, irreversible Ischemia and limb ischemia secondary to trauma or graft occlusion of previous Bypass surgery were excluded from the study. Results: A total of 49 (36 males and 13 females) patients were included in the study. Thirty-three (67.3%) patients underwent embolectomy for lower while 16 (32.6%) for upper limb ischemia. Ten (20.4%) patients had fasciotomy while 7 (14.2%) patients underwent re embolectomy. In 5 (10.2%) patients vascular bypass had to be done. Seven (14.2%) patients underwent minor amputations while 5 (10.2%) had major limb amputations. Two (4%) patients died of reperfusion injury. Overall 42 (85.7%) limbs were salvaged. Conclusion: Embolectomy is effective in late presenting acute limb ischemia with viable extremity and should be offered to these patients.Keywords: Acute Limb Ischemia; Fasciotomy; Embolectomy

Author Biographies

Afzal Siddique, CMH Rawalpindi

Registrar, Department of vascular surgery, combined military hospital Rawalpindi.

Nauman Imtiaz, CMH Rawalpindi.

Head of department, Vascular surgery.

Khalid Pervaiz, CMH Rawalpindi

Lt. Col.Registrar, Department of vascular surgery, combined military hospital Rawalpindi.

Kishwar Ali, CMH Rawalpindi

Registrar, Department of vascular surgery, combined military hospital Rawalpindi.

Rai Ahmad, CMH Rawalpindi

Registrar, Department of vascular surgery, combined military hospital Rawalpindi.

Fazal-e Haider, CMH Rawalpindi

Registrar, Department of vascular surgery, combined military hospital Rawalpindi.


Simon F, Oberhuber A, Floros N, Busch A, Wagenhauser MU, Schelzig H, et al. Acute Limb Ischemia-Much More Than Just a Lack of Oxygen. Int J Mol Sci 2018;19(2):374.

McNally MM, Univers J. Acute Limb Ischemia. Surg Clin North Am 2018;98(5):1081–96.

Van DH, Boesmans E, Defraigne JO. [Acute limb ischemia]. Rev Med Liege 2018;73(5-6):304–11.

Karnabatidis D, Spiliopoulos S, Tsetis D, Siablis D. Quality improvement guidelines for percutaneous catheter-directed intra-arterial thrombolysis and mechanical thrombectomy for acute lower-limb ischemia. Cardiovasc Intervent Radiol 2011;34(6):1123–36.

Goldberg A, Stansby G. Surgical talk: lecture notes in undergraduate surgery. Singapore; London: World Scientific, 2012; p.234.

Khan MI, Nadeem IA. Revascularization of Late Presenting Acute Limb Ischaemia And Limb Salvage. J Ayub Med Coll Abbottabad 2016;28(2):262–6.

Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 1997;26(3):517–38.

Kempe K, Starr B, Stafford JM, Islam A, Mooney A, Lagergren E, et al. Results of surgical management of acute thromboembolic lower extremity ischemia. J Vasc Surg 2014;60(3):702–7.

Ender Topal A, Nesimi Eren M, Celik Y. Management of non-traumatic acute limb ischemia and predictors of outcome in 270 thrombembolectomy cases. Int Angiol 2011;30(2):172–80.

Iyem H, Eren MN. Should embolectomy be performed in late acute lower extremity arterial occlusions? Vasc Health Risk Manag 2009;5:621–6.

Nekkanti MK, Suresh KR, Motukuru V, Kolalu S, Kabra A. Outcomes of limb and life in patients with acute lower limb schema presenting before and after the “golden six hours”. Int J Adv Med 2018;5(4):788–97.



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