Thromboembolectomy in Acute Arterial Occlusion

급성 동맥폐색증에서 혈전색전 제거술 -48례 경험-

  • 김진희 (부산대학교 의과대학 흉부외과학교실)
  • Published : 2000.10.01

Abstract

Background : Even though there were developments in various treatment techniques for acute arterial occlusion this disease still has high rate of mortalities and limb amputations. We investigated the combined diseases symptoms location of occlusion type of treatment complication and prognosis in our patients. Meterial and methods: This study recruited 48 patients(42 men, 6 women, mean age 57.7 years) who received the operation from January 1995 toDecember 1998. We investigated the post-operation course via medical record review or telephone interview with patients or their family members. Result: The most common combined diseases were atherosclerosis in 30 patients. other diseases were 17 diabetes mellitus 16 hypertension and 12 atrial firillation. Pain and clod sensation were noticed in all patients paresthesia in 5 patients fibrillation. Pain and cold sensation were noticed in all patients paresthesia in 5 patients and lower extremity paralysis in 11 patients. In 29 patients the time interval from the onset of symptom to admission was over 72 hours and 15 patients were admitted within 24 hours. The distribution of arterial occlusion location was at 28 femoral arteries 14 popliteal arteries and 6 iliac arteries. All the patients were received embolectomy and 5 patients were received additional bypass grafting. Postoperative complications were 12 reocclusions. 6 compartment syndromes 6 skin necrosis and 2 acute renal failure. The mortality rate was 16.7%(8/48) and the amputation rate was 25% Conclusion : This study revealed 25% reocclusion 25% limb amputation and 16.7% mortaliyt. To improve the prognosis of acute lower extrements arterial occlusion early diagnosis and understand the underlying diseases prompt treatment and operation additional operation including interventional radiologic examination and thorough postoperative care would be appreciated.

Keywords

References

  1. Guerison Bull Acad Med(paris) v.66 Embolie femorale au cours diun retrecissment mitral pur arteiotomie Labey G, (eited by)Mosny M, Dumont MJ.
  2. Surg Gynecol Obstet v.116 A method for extraction of arterial emboli and thrombi Fogarty TJ, Granley JJ, Krause RJ,(et al)
  3. 대한매관외과학회지 v.12 급성 동맥 폐색증 김영찬, 이영철, 김영철
  4. 대한매관외과학회지 v.14 급성 하지 동맥폐색증의 임상적 고찰 박원철, 이경근, 채권목, 노병석, 소병준
  5. 대한매관외과학회지 v.15 급성 하지 동맥폐색증의 치료 김도균, 박호철, 고영관, 고석환, 주홍재
  6. Surgery v.84 Management of acilte lower extremety arteral tschemia due to embolism and thrombosis Blaisdell FW, Steele M, Allen RE
  7. Arch Surg v.119 Acute arterial thrombosis of the lower extremity Camblia RP, Abott WA.
  8. N Engl J Med v.290 Acute arterial occuluston Thompson JE
  9. Arch Surg v.117 Immediate and longterm outcome of acute arterial acclusion of the extremities: the effect of added vascular reconstruction Field T, Littoy FN, Baker WH
  10. Surgery v.55 no.1 Peripheral arterial embolism changing concepts Crauley JJ, Krause RJ, Strasser ES, Hafinet CD, Forgaty TJ
  11. Surg Gynecol Obstel v.123 Peroperal arterial embolism Baker CF, Rosato FE, Roberts B.
  12. Surgery v.67 no.1 Arterial embolectomy : A 20 year exprence with 163 cases Thomson JE, sigler L, Raut PS, Austin DJ, Patman RD.
  13. Ann Surg v.140 no.3 Arterial embolism(recent prgress) Waren R, Linton PR, Seannell JG.
  14. Acta Chir Scand v.1434 Analysis of factors affecting limb salvage and moltalityafter embolectomy Erlkson I, Holmberg JT,
  15. Circuration v.83 no.suppl I Intra arterial urokinse as the initial thrapy for acutely ischemic lower limbs Mc Namara TO, Bombetger RA, Merehant RF
  16. Am J Surg v.144 Thrombolysis of pertperal artertal and graft occlusion : Improved results using high-does workinase Mc Namara TO, Fischer JR
  17. Am J Surg v.148 Peripheral artertal emboli Connett MC, Murray DH
  18. Surg v.79 Changing clinical trends in patients with pertpheral artertal emboli Highy DW, Tilney NL.
  19. Surg Clin Am v.66 no.2 Artrtal emborectomy : A 34-years expertence with 400 cases Penetra T, Thomson JE, Talkington CM, Gaitt WV, Smith BL
  20. Surg Clin North Am v.78 no.4 Diagnostic and interventional angisocopy John VW, Ibrahim Eid