To the Editor.—In "Arterial Thromboembolism: A 20-Year Perspective," Tawes et al1 strongly advocated the routine use of heparin in the postoperative management of all patients undergoing embolectomy for acute thromboembolic occlusion of the lower extremity. This is a debatable point,2 and our experience in the treatment of 127 consecutive patients over a three-year period, 1980 to 1983, is contrary to their recommendation.
A total of 155 embolectomies were performed, including nine cases of aortic occlusions and 17 cases of multiple occlusions. Elderly atherosclerotic patients made up the main bulk of our experience. Of the patients, 25% were treated after 72 hours or more from the time of onset of ischemia, and 17.5% presented with a severe degree of ischemia (neurologic loss of tissue damage). We had a 17% mortality rate and 6.3% amputation rate calculated for patients treated. Sixty-one of the patients were treated with heparin postoperatively.