Paradoxical embolism in peripheral ischaemia: diagnosis of venous to arterial shunting by transcranial doppler

Rare Forms of Peripheral Arterial Embolism: Review of 11 Cases

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.