Clinical and Histopathological Correlation in Cases Undergoing Embolectomy for Acute Extremity Ischemia

Abstract

Aim: Acute extremity ischemia (AEI) is a disease in which the arterial perfusion of the limb is suddenly reduced, mostly due to a thromboembolic condition. There is a need for an urgent evaluation and intervention, most commonly surgical embolectomy. Surgically removed thrombus materials can provide information about the disease and its process. Method: Patients who underwent embolectomy for acute extremity ischemia between November 2021 and March 2022 were retrospectively analyzed, and the obtained embolectomy materials were histopathologically evaluated. Results: We included 32 cases of patients who underwent embolectomy surgery for AEI. The histopathological evaluation of the materials taken from these cases determined that the thrombus age was compatible with the first 48 hours. Malignant epithelial tumor cells were detected in one case. In addition, we assessed and showed that re-intervention was significantly higher in cases with a high fibrin score with chronic peripheral artery disease. Conclusion: We believe that the histopathological evaluation of the materials removed from patients who underwent embolectomy surgery for acute extremity ischemia can aid in diagnosis, guide treatment, and provide valuable prognostic information.

Keywords

• Acute extremity ischemia
• embolectomy
• fibrin thrombus
• histopathology

Akut Ekstremite İskemisi Nedeniyle Embolektomi Yapılan Olgularda Klinik ve Histopatolojik Korelasyon

Abstract

Amaç: Akut ekstremite iskemisi (AEI), çoğunlukla tromboembolik bir duruma bağlı olarak, ekstremite arteriyel perfüzyonunun aniden azaldığı bir hastalıktır. Çoğunlukla cerrahi embolektomi olmak üzere acil bir değerlendirme ve müdahaleye ihtiyaç vardır. Ameliyatla çıkarılan trombüs materyalleri hastalık ve süreci hakkında bilgi verebilir. Yöntem: Kasım 2021-Mart 2022 tarihleri arasında akut ekstremite iskemisi nedeniyle embolektomi yapılan olgular retrospektif olarak incelendi ve elde edilen embolektomi materyalleri histopatolojik olarak incelendi. Bulgular: AEI nedeniyle embolektomi ameliyatı yapılan 32 olgu çalışmaya dahil edildi. Bu olgulardan alınan materyallerin histopatolojik değerlendirmesi sonucunda trombüs yaşının ilk 48 saat ile uyumlu olduğu belirlendi. Bir olguda alınan materyalde malign epitelyal tümör hücreleri saptandı. Ayrıca değerlendirmede kronik periferik arter hastalığı olan yüksek fibrin skorlu olgularda tekrar girişimin anlamlı olarak daha yüksek olduğu görüldü. Sonuç: Akut ekstremite iskemisi nedeniyle embolektomi ameliyatı geçiren hastalarda çıkarılan materyallerin histopatolojik olarak değerlendirilmesinin tanı ve tedaviye katkı sağlamanın yanı sıra prognostik bilgi sağlayacağı düşünülmektedir.

Keywords

• Akut ekstremite iskemisi
• embolektomi
• fibrin trombüs
• histopatoloji

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