下肢慢性缺血合并急性血栓形成的外科治疗

目的 探讨治疗下肢慢性缺血合并急性血栓形成的最佳外科治疗手段.方法 回顾性分析2000年1月～2010年10月我科收治的26例下肢慢性缺血合并急性血栓形成患者的临床资料,比较单纯采用股动脉切开导管取栓术组(10例)与股-腘动脉切开取栓联合动脉重建手术组(16例)的疗效.结果随访时间1～114个月,单纯股动脉切开术组中的...

Surgical treatment for chronic lower limb ischemia complicated with acute arterial thrombosis

Objective To explore the optimal treatment for chronic lower limb ischemia complicated with acute arterial thrombosis.Methods From Jan.2000 to Oct.2010,the clinical data of 26 patients with chronic lower limb ischemia complicated with acute arterial thrombosis were retrospectively analyzed.Then the efficacy was compared between simple femoral artery embolectomy with Fogarty catheter(10 patients) and femoropoplilteal embolectomy combined with artery reconstruction(16 patients).Results During the followed-up period(from 1 to 114 months),in simple femoral artery embolectomy group,the amputation rate was 70%(7/10),and vascular bypass was performed on 3 cases within the first year postoperatively.In femoropoplilteal embolectomy combined with artery reconstruction group,the technical success rate was 100%,the symptoms of chronic lower limb ischemia improved in 13 patients(81.3%),and hind limb ischemia because of bypass occlusion occurred in the other 3 cases,in whom 2 recovered after conservative therapy and one patient needed a second-bypass.Conclusion Femoropoplilteal embolectomy combined with suitable artery reconstruction is more effective than simple femoral artery embolectomy with Fogarty catheter.The value of the profunda artery when the superficial femoral artery occluded should be emphasized and profundaplasty is an effective alternative to distal bypass in selected patients with chronic lower limb ischemia.