Surgical treatment of acute lower extremity ischemia:a report of 96 cases / 中国普通外科杂志

ABSTRACT

Objective To study methods of salvage therapy for acute lower extremity(ALEI) ischemia.(Methods) A restrospectively analyzsis was made on the clinical data of 96 patients with consecutive 106 ALEI limbs.In which Fogarty catheter embolectomy was used as the initial treatment for ALEI in a regular(operating) room or in an intervention therapy room under DSA monitoring,and graft bypass after embolectomy was performed on 8 cases(12 limbs).Results In 70 cases(75 limbs) successful embolectomy of the(iliac),femoral,popliteal and tibial artery was achieved.In 11 cases(12 limbs) embolectomy at distal to the popliteal artery was unsuccessful.Eight cases(12 limbs) with obstruction proximal to the femoral artery were treated by axillofemoral bypass in 4 cases,and femorofemoral bypass in 4 cases.One case of thoracoabdominal aortic dissection aneurysm and lower extremity ischemia had fenestration of the abdominal aoric dissection.Proximal embolectomy and distal amputation was performed in 6 cases.Fimally,76(79.2%) cases had(salvaged) limbs,11(11.4%) patients had amputated limbs,and 9(9.4%) patients died.Seventy-six(patients)(85 limbs) were followed up for 1 to 38 months,7 cases(7 limbs) were reoperated on because of recurrent embolism.Conclusions Embolectomy is the effective treatment method for ALEI.Embolectomy(under) DSA monitoring can improve therapeutic results.The prognosis lies on the duration and extent of(ischemia),and management of complications.