Clinical and Angiographic Correlations in Arterial Stenosis

Not more than 30 years ago surgeons could do no better than amputate a gangrenous extremity after all conservative measures had failed. In the late 20's and early 30's our service began to perform two operations that saved many limbs. Embolectomies were done and are still being done in the first 6 to 10 hours after development of an acute embolism to the lower extremities.1Sympathectomies were advocated to enlarge the terminal capillary bed and to decrease the resistance in collateral vessels in patients with occlusion of the major arterial pathways.2Today, another step forward may be made by recognizing and treating arterial stenosis, the forerunner of many vascular catastrophies.3When peripheral embolism and thromboangiitis obliterans are excluded, both of which may produce stenosis by partial canalization of the clot, the overwhelming problem is that of the arteriosclerotic patient whose subintimal atheroma protrudes into the wall, narrows