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December 1962

Arterial Embolism: Modern Concepts

Author Affiliations

Research Fellow in Surgery, Harvard Medical School and the West Roxbury Veterans Administration and Peter Bent Brigham Hospitals (Dr. Ouchi); Clinical Professor of Surgery, Harvard Medical and Chief of the Surgical Service, West Roxbury Veterans Administration Hospital (Dr. Warren).; From the Departments of Surgery, Veterans Administration Hospital, West Roxbury, Mass., and Peter Bent Brigham Hospital, Boston.

Arch Surg. 1962;85(6):905-910. doi:10.1001/archsurg.1962.01310060041010

The management of arterial embolism has passed through 3 phases since the first successful embolectomy was performed by Labey in 1911.3 The earliest phase, lasting until about 1935, was characterized by isolated successes from embolectomy done soon after the episode in patients with peripheral embolism, but the salvage of limb and life was low. Successful aortic embolectomy or embolectomy for late embolism was not reported.

In the second phase, lasting from 1935 to 1950, newer methods of support of the patient, through operation and the growing recognition by the medical profession that patients with embolism should be referred early for operative treatment, bore fruit. Limb salvage was increased to 85%, aortic embolectomy was successfully accomplished in several instances, and it became understood that "lateness" was not a contraindication to the operation provided the fate of the limb was not already settled.4 The mortality from the associated heart disease