Management of acute arterial embolism in the upper extremities
- VernacularTitle:急性上肢动脉栓塞的外科治疗
- Author:
Zhe CHEN
;
Haidi HU
;
Qing CHANG
;
Chong LIU
;
Jian ZHANG
;
Zhiquan DUAN
;
Shijie XIN
- Publication Type:Journal Article
- Keywords:
Arterial occlusive diseases;
Vascular surgical procedures;
Upper extremity;
Prognosis
- From:
Chinese Journal of General Surgery
2008;23(11):869-871
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate risk factors of the prognosis in acute arterial embolism of the upper extremities. Methods The clinical data of 62 consecutive patients admired in our hospital with the diagnosis of acute arterial embolism in the upper extremities, from July 1988 to January 2008, were retrospectively reviewed. The risk factors including age, gender, cardiac function, location of embolism, embolectomy and duration of iaehemia were analyzed by cumulative Loots regression. Results There were 62 patients, 33 men and 29 worsen, with a mean age of 63. 5 years (35～86 years). Among them, 37 patients received Fogarty embolectomy and 25 patients received medical treatment including thrombolysis, anticoagulation and antiplatelet therapy because of poor risk for surgery. The iachemic status meliorated in 55 patients (88.7%) with 2 patients receiving amputation and 2 patients dying during the peri-operative period. The result of cursulative Logits regression shewed that the duration of ischemia, cardiac function and embolectomy played the significant role on the prognosis (P < 0.01 ), but age, sex and the location of embolism did not show the significant role. In those only receiving the medical treatment, 23 patients restored blood flow to different degree. Conclusions Embolectomy with Fogarty catheter within 8 hours of onset was the most effective treatment for acute arterial embolism in the upper extremities. For peor-risk patients, early medical treatment including thrombolysis, antieoagulation and antiplatelet treatment, can also restore the blood flow in the isehemie limbs.
