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1 : 7-83, Fogarty 3 8% 6 : 7-83, (Tel : ) % Table 1 6 1

2 Fogarty Champion % 2, % Haimovici % % % ~ % 6~ % 0% % 3 7%, % Haimovici 2 28% 56% 8% 8% 30% 70% 75% 70% S Fogarty 20

3 Table 1 Acute arterial obstruction of upper extremities Case Age Sex Site of obstruction Time from onset to operation (hour) Cause of obstruction,aso ASO Symptom paleness cyanosis ASO DM H/T Iatrogenic average : Atrial fibrillation, ASO : Arteriosclerosis obliterance, DM : Diabetes mellitus, H/T : Hypertension, MS : Mitral stenosis MS Angiography Ultrasonic cardiac echography Complication reobstruction Past history Cataract Arterial obstruction of bilateral lower extremities Left atrial thrombus Myocardial Angina pectoris Coarctation complex 21

4 Fogarty Fogarty Haimovici 2 3% 23.1% 1.1% 11.6% 8.8% 2% 1.% ) Champion, H.R. and Gill, W. : Arterial embolus to the upper limb. Br. J. Surg., 60 : , ) Haimovici, H. : Arterial embolism of the extremities and technique of embolectomy. In : Vascular surgery : principles and techniques, Haimovici, H. et al. Ed., 3rd ed., Norwalk, 18, Appleton & Lange, pp ),, :., 33 : 802, 13. ),, :., : , ),, :., 3 : 655, 1. 6),, : 13., 5 : 77-7, 16. 7),, :., 6 : , 17. 8),, :., 27 : , 18. ) Stroke Prevention in Atrial Fibrillation Investigators: Predictors of thromboembolism in atrial fibrillation : I. Clinical features of patients at risk. Ann. Intern. Med., 116 : 1-5, ) Kopecky, S.L., Gersh, B.J., McGoon, M.D. et al. : The natural history of lone atrial fibrillation. A population-based study over three decades. N. Engl. J. Med., 317 : 66-67, ),, :., 5 : ,

5 Acute Arterial Obstruction of the Upper Extremities Teruyuki Koyama, Shigeki Funaki, Koichi Nishimura, Masaaki Kanno, Hiroyuki Abe and Tomizo Hiekata Division of Cardiovascular Surgery, Department of Surgery, St. Marianna University Yokohama City Seibu Hospital Key words : Acute arterial obstruction, Thromboembolectomy, Atrial fibrillation We encountered 10 cases of acute arterial obstruction of the upper extremities consisting of 6 male and female cases during the past decade. The age ranged from 6 to 7 years with a mean age of 62. years. Causes were atrial fibrillation in 8, arteriosclerosis in one and iatrogenic in one. Symptoms were paresthesia in 8, paleness in 6, in 5, pain in, cyanosis in one. The site of obstruction were on the in cases and on the in 6 cases. The involved arteries were in 3 cases and in 7 cases. Angiography was carried out in 6 cases. Although thrombolytic therapy was performed in 5 cases, surgical treatment was required in all cases. Thromboembolectomy using a Fogarty catheter under local anesthesia was successfully performed through the. The ischemic time ranged from to 8 hours with a mean time of 13.7 hours. with hemiplegia was a complicating condition in 3 cases. The prognosis of the other 7 cases without cerebral was satisfactory. Anticoagulant therapy is necessary for aged patients with atrial fibrillation to prevent thromboembolism. Thromboembolectomy can be performed safely under local anesthesia through a cubital incision. Angiography is not always necessary. Anticoagulant therapy should be continued following thromboembolectomy. (Jpn. J. Vasc. Surg., 7-83, 2000) 23

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