ACUTE UPPER LIMB ISCHAEMIA IN DIABETIC PATIENTS - A RECENT EXPERIENCE

• Published in: South African journal of surgery Vol. 55; no. 3; p. 78
• Main Authors: du Toit, R, Abdool-Carrim, A T O, Monareng, T
• Format: Journal Article
• Language: English
• Published: South Africa 01-09-2017
• ISSN: 0038-2361

The outcome of acute upper limb ischaemia in diabetic patients is not well known. We report our recent experience with 5 patients.
Retrospective case reviews.
All patients presented with Rutherford 2b ischaemia at a median 1.6 days after symptom onset. Age range: 43-76 years. M:F 1:4. Mean HbA1c: 10.1% (range 6.1 - 14.0) Mean LDL cholesterol: 3.1g/dL (range 1.61 - 4.80) Other comorbidities included: Ischaemic heart disease, atrial fibrillation, dyslipidaemia, hypertension, morbid obesity. One patient was an ex-smoker. Four patients had preoperative CT angiograms. All patients underwent Fogarty catheter embolectomy of the forearm and arm arteries as initial procedure as well as forearm fasciotomy in 3 patients.
Acute upper limb ischaemia in patients with diabetes appears to carry a grave prognosis for limb salvage (20% in this group). Re-intervention was associated with subsequent amputation. Proximal arterial disease can occur but the common finding of occlusive disease in the run-off vessels of the arm, as in this group, may account for the high limb-loss rate.