Rare Forms of Peripheral Arterial Embolism: Review of 11 Cases

Markovic Miroslav, MD, MSc; Davidovic Lazar, MD, PhD; Mikic Aleksandar, MD, MSc; Djoric Predrag MD, MSc; Putnik Svetozar MD, MSc


Vascular. 2005;13(4):222-229. 

In This Article

Abstract and Introduction

The purpose of this study was to present 11 patients operated on owing to rare forms of peripheral arterial embolism at the Institute for Cardiovascular Diseases of the Serbian Clinical Center over a period of 20 years.

Three patients were operated on owing to a foreign body embolism, two owing to a septic embolism, three owing to emboli that originated from malignant tissues, two owing to an embolization from cardiac myxoma, and one owing to an embolism from a myxomatous atrial septal defect. The preoperative evaluation included clinical examination, laboratory findings, and electrocardiography; in the majority of cases, ultrasonography and angiography were performed.

Surgical treatment included foreign body extraction in three cases; thromboembolectomy in seven cases, and artery resection and saphenous graft interposition in one patient with septic embolism. In addition, three cardiosurgical procedures were done: aortic valve replacement in the patient with a septic embolism and tumor excision in patients with atrial myxoma.

In addition to the usual clinical signs of acute limb ischemia, in the rare forms of arterial embolism, the presence of certain uncommon clinical symptoms was also observed. The early results of vascular surgical treatment were very good in all patients. Further follow-up revealed a poor prognosis in patients with malignant arterial embolism.

The most common type of arterial embolus is the thromboembolus, which most frequently originates from the heart as a result of various pathologic conditions, such as myocardial infarction, cardiac arrhythmias, valvular diseases, congestive myocardiopathy, and ventricular aneurysms of the heart.[1,2] Arterial aneurysms are the second most common source of thromboemboli, followed by ulcerated atherosclerotic plaques of the major arteries.[2] Cholesterol emboli from atherosclerotic arteries, cardiac myxoma, venous thrombus that passes into the arterial system via a right-to-left atrial or ventricular shunt (paradoxal embolism), bacterial endocarditis, and malignant tumors are some rare causes of arterial embolism.


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