Embolies artérielles des membres

Abstract

Arterial embolism of extremities results from the obstruction of the artery by a blood clot originating in the heart and travelling through the bloodstream. Rheumatismal causes have been progressively discarded drawing attention to atheromatosis. Apart from cardiac embolism, experience has shown the existence of emboli developing in other arteries and veins called paradoxical emboli. The aetiology of emboli has been supplemented by modern techniques, including the Holter electrocardiogram (ECG), transoesophageal echocardiography (TEE), computed tomography angiography (CTA) and magnetic resonance angiography (MRA). The role of arteriography is to be considered based on the degree of emergency and the condition of artery before blockage. Technology advances have also improved the treatment of emboli, together with the Forgarty's catheter which is still widely used aspiration thrombectomy can be achieved percutaneously. Catheter directed thrombolysis is another useful technique in the treatment of distal ischemia. However, in pathologic arteries, embolism often requires transluminal dilatation or by pass grafting. Nonetheless, the prognosis tends to remain severe due to a high risk of amputation and death related to the aetiology, terrain and other embolic localizations.