PT  - JOURNAL ARTICLE
AU  - Thomas L. Forbes
AU  - Guy DeRose
AU  - Kenneth A. Harris
TI  - Is long-term anticoagulation after acute thromboembolic limb ischemia always necessary?
DP  - 2002 Oct 01
TA  - Canadian Journal of Surgery
PG  - 337--340
VI  - 45
IP  - 5
4099  - http://canjsurg.ca/content/45/5/337.short
4100  - http://canjsurg.ca/content/45/5/337.full
SO  - CAN J SURG2002 Oct 01; 45
AB  - 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.