Is long-term anticoagulation after acute thromboembolic limb ischemia always necessary?

Thomas L. Forbes, Guy DeRose, Kenneth A. Harris

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objective: After thromboembolectomy, patients with acute limb ischemia often receive anticoagulant therapy to prevent recurrent events. Patients with atrial fibrillation or cardiac thrombus have a higher risk of recurrent emboli than those without these risk factors. This study examines the importance of long-term anticoagulation in these 2 groups. Design: A review of patients presenting with acute limb ischemia over a 5-year period (1994-1999). Setting: A university-affiliated medical centre. Patients: Fifty patients divided into 2 groups: 19 (38%) patients with atrial fibrillation (group 1) and 31 (62%) patients with no atrial fibrillation or cardiac thrombus (group 2) as confirmed by transthoracic echocardiography. Intervention: All patients underwent surgical thromboembolectomy and received postoperative anticoagulant therapy. Outcome measures: Mortality, limb loss, further thromboembolic events and bleeding complications as determined by telephone survey. Results: There was a significant difference in 5-year survival (group 1, 84%; group 2, 64%) and early limb loss (group 1, 0%; group 2, 13%). Further thromboembolic events and bleeding complications were rare but were more common in group 1. In group 2 there were no instances of recurrent thromboemboli and no bleeding complications although only 39% of patients in this group were taking angicoagulants at the end of the study period. Conclusions: Patients with extremity thromboemboli without atrial fibrillation or cardiac thrombus may not be at the same risk for recurrent events as those with these risk factors, and long-term anticoagulant therapy may not be as necessary in this group.

Original languageEnglish
Pages (from-to)337-340
Number of pages4
JournalCanadian Journal of Surgery
Volume45
Issue number5
StatePublished - Oct 2002
Externally publishedYes

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