Clinical application of ultrasound guided Fogarty balloon catheter in arterial crisis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Xiaodong ¹ ,  WANG Pei ¹ , YU Changyu ¹ , YAN Xiaowei ² , YIN Jing ³

1. Department of Hand and Foot Surgery, Chengde Medical College Affiliated Hospital, Chengde Hebei, 067000, P.R.China;
2. Department of Critical Care Medicine, Chengde Medical College Affiliated Hospital, Chengde Hebei, 067000, P.R.China;
3. Department of Vascular Surgery, Chengde Medical College Affiliated Hospital, Chengde Hebei, 067000, P.R.China;

Corresponding author：

WANG Pei, Email: cdgkwp@qq.com

Keywords：

Color doppler ultrasonography; Fogarty balloon catheter; replantation of severed limb; arterial crisis

DOI：

10.7507/1002-1892.201705057

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the effectiveness of arterial crisis after replantation of limb treated by ultrasound guided Fogarty balloon catheter. Methods Between January 2012 and July 2016, 27 patients suffered from arterial crisis after replantation of limb were treated with ultrasound guided Fogarty balloon catheter combined with thrombolytic anticoagulant. There were 18 males and 9 females with the age of 19-51 years (mean, 32 years). The limb mutilation position was at knee joint in 3 cases, lower limb in 9 cases, ankle joint in 6 cases, elbow joint in 2 cases, forearm in 4 cases, and wrist joint in 3 cases. The arterial crisis happened at 2.5-18 hours (mean, 7.5 hours) after limb replantation surgery. Color doppler ultrasonography was used to diagnose the arterial thrombosis, finally the anastomotic thrombosis were found in 16 cases, non-anastomotic thrombosis in 7 cases, and combined thrombosis in 4 cases. All the thrombosis were deteced in the arteries with the length of 0.8-3.9 cm. Results No complication such as vascular perforation, rupture, air embolism, thromboembolism, wound infection, or sepsis happened after operation. Arterial crisis occurred again in 3 cases at 1.5-13.5 hours after limb replantation and treated by arterial exploration, 1 case was treated successfully; 2 cases had arterial occlusion and partial necrosis of limb, and got amputation treatment at last. The rest 24 cases survived with the incision healing by first stage. In the 24 cases, 1 case suffered from acute myonephropathic metabolic syndrome and corrected after hemodialysis; 1 case suffered from acute liver functional damage and corrected by comprehensive treatment of internal medicine. The 24 patients were followed up 7-38 months (mean, 11 months). At last follow-up, blood supply of the limb was good with normal skin temperature and improved sense of feeling, activity, and swelling. According to Chinese Medical Association of hand surgery to the upper extremity function assessment standard, the results were excellent in 12 cases, good in 8 cases, and fair in 4 cases with an excellent and good rate of 83.3%. Conclusion Ultrasound guided Fogarty balloon catheter treatment of posterior replantation of arterial crisis can accurately locate the thrombosis, get the thrombus fast and invasive minimally to avoid the blind and repeated thrombectomy, and obtain certain effectiveness.

Citation： LI Xiaodong, WANG Pei, YU Changyu, YAN Xiaowei, YIN Jing. Clinical application of ultrasound guided Fogarty balloon catheter in arterial crisis. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(10): 1220-1224. doi: 10.7507/1002-1892.201705057 Copy

1.	曾文超, 郭洪敏, 王洪宾, 等. 复杂肢体离断再植的临床治疗体会. 实用骨科杂志, 2015, 21(2): 184-186.0.
2.	周喆刚, 万圣祥, 肖颖锋, 等. 游离皮瓣失败病例的原因及临床处理结果分析. 实用骨科杂志, 2016, 22(9): 802-805.0.
3.	潘生德, 顾玉东, 侍德. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.0.
4.	石健, 赵钢, 程春生, 等. 前列地尔对皮瓣移植患者术后凝血系统的影响. 创伤外科杂志, 2016, 18(9): 560-562.0.
5.	Wong AK, Joanna Nguyen T, Peric M, et al. Analysis of the risk factors associated with microvascular free flap failure using a multi-institutional database. Microsurgery, 2015, 35(1): 6-12.
6.	唐军, 张艳阁, 黄建琼, 等. 下肢血管畸形的手术治疗. 中国修复重建外科杂志, 2017, 31(5): 638-640.0.
7.	李小东, 刘士波, 严晓薇, 等. Fogarty球囊导管在断肢再植术后动脉危象中的应用. 中国煤炭工业医学杂志, 2017, 20(4): 409-412.0.
8.	曹树伟, 张静, 郭志勇, 等. 介入术联合术后抗凝溶栓治疗下肢深静脉血栓形成效果观察. 山东医药, 2016, 56(8): 54-56.0.
9.	黎宏庄, 游文霞, 李国兴. SolitaireTMAB取栓与尿激酶静脉溶栓治疗急性颅内大动脉闭塞的效果比较. 广东医学, 2016, 37(7): 1060-1063.0.
10.	Desancho MT, Bardarova S, Chapin J. Adherence to guidelines for perioperte management of anticoagula-tion results in decreased bleeding complications: a single-centre experience. Blood Coagul Fibrinolysis, 2015, 26(4): 426-429.
11.	龚凯, 黄道景, 张亚明. 急性下肢缺血诊治的临床分析. 中国实用医药, 2017, 12(3): 14-16.0.
12.	郑树法, 庄勇, 余良宏, 等. 术中B超实时监测在幕上病变精准手术中的临床应用. 福建医科大学学报, 2015, 49(2): 131-135.0.
13.	程光森, 许卫国, 陈加源, 等. DSA监视下Fogarty球囊导管在急性肢体动脉栓塞中的应用. 实用放射学杂志, 2015, 31(8): 1348-1350.0.
14.	杨志, 林龙英, 王家兴. Fogarty球囊导管在自体动静脉内瘘取栓术中的应用. 中国血液净化, 2016, 15(10): 576.0.
15.	刘建峰, 高金玲, 李辉, 等. Solitaire AB型支架取栓术治疗急性大脑中动脉闭塞. 山东医药, 2016, 56(43): 15-18.0.
16.	张子龙, 张克难, 庞典付, 等. 多种无创性检测指标与股腘动脉硬化闭塞症病变程度的相关性分析. 福建医科大学学报, 2016, 50(3): 186-191.0.
17.	丁杭, 韩涛, 程章波. 19例肢体假性动脉瘤临床分析. 福建医科大学学报, 2015, 49(3): 193-194.0.
18.	刘晓明, 向明, 车正兰, 等. 彩色多普勒超声评价自体动静脉内瘘急性血栓形成中用Fogarty球囊导管取栓的临床应用. 临床超声医学杂志, 2016, 18(7): 488-490.0.
19.	徐新, 韩秋果, 刘巍立, 等. Fogarty导管取栓治疗急性肠系膜上动脉栓塞的临床疗效及安全性. 中华普通外科杂志, 2016, 31(9): 787-788.0.
20.	Tall J, Björklund TC, Skogh AC, et al. Vascular complications after radiotherapy in head and neck free flap reconstruction: Clinical outcome related to vascular biology. Ann Plast Surg, 2015, 75(3): 309-315.

1. 曾文超, 郭洪敏, 王洪宾, 等. 复杂肢体离断再植的临床治疗体会. 实用骨科杂志, 2015, 21(2): 184-186.0.
2. 周喆刚, 万圣祥, 肖颖锋, 等. 游离皮瓣失败病例的原因及临床处理结果分析. 实用骨科杂志, 2016, 22(9): 802-805.0.
3. 潘生德, 顾玉东, 侍德. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.0.
4. 石健, 赵钢, 程春生, 等. 前列地尔对皮瓣移植患者术后凝血系统的影响. 创伤外科杂志, 2016, 18(9): 560-562.0.
5. Wong AK, Joanna Nguyen T, Peric M, et al. Analysis of the risk factors associated with microvascular free flap failure using a multi-institutional database. Microsurgery, 2015, 35(1): 6-12.
6. 唐军, 张艳阁, 黄建琼, 等. 下肢血管畸形的手术治疗. 中国修复重建外科杂志, 2017, 31(5): 638-640.0.
7. 李小东, 刘士波, 严晓薇, 等. Fogarty球囊导管在断肢再植术后动脉危象中的应用. 中国煤炭工业医学杂志, 2017, 20(4): 409-412.0.
8. 曹树伟, 张静, 郭志勇, 等. 介入术联合术后抗凝溶栓治疗下肢深静脉血栓形成效果观察. 山东医药, 2016, 56(8): 54-56.0.
9. 黎宏庄, 游文霞, 李国兴. SolitaireTMAB取栓与尿激酶静脉溶栓治疗急性颅内大动脉闭塞的效果比较. 广东医学, 2016, 37(7): 1060-1063.0.
10. Desancho MT, Bardarova S, Chapin J. Adherence to guidelines for perioperte management of anticoagula-tion results in decreased bleeding complications: a single-centre experience. Blood Coagul Fibrinolysis, 2015, 26(4): 426-429.
11. 龚凯, 黄道景, 张亚明. 急性下肢缺血诊治的临床分析. 中国实用医药, 2017, 12(3): 14-16.0.
12. 郑树法, 庄勇, 余良宏, 等. 术中B超实时监测在幕上病变精准手术中的临床应用. 福建医科大学学报, 2015, 49(2): 131-135.0.
13. 程光森, 许卫国, 陈加源, 等. DSA监视下Fogarty球囊导管在急性肢体动脉栓塞中的应用. 实用放射学杂志, 2015, 31(8): 1348-1350.0.
14. 杨志, 林龙英, 王家兴. Fogarty球囊导管在自体动静脉内瘘取栓术中的应用. 中国血液净化, 2016, 15(10): 576.0.
15. 刘建峰, 高金玲, 李辉, 等. Solitaire AB型支架取栓术治疗急性大脑中动脉闭塞. 山东医药, 2016, 56(43): 15-18.0.
16. 张子龙, 张克难, 庞典付, 等. 多种无创性检测指标与股腘动脉硬化闭塞症病变程度的相关性分析. 福建医科大学学报, 2016, 50(3): 186-191.0.
17. 丁杭, 韩涛, 程章波. 19例肢体假性动脉瘤临床分析. 福建医科大学学报, 2015, 49(3): 193-194.0.
18. 刘晓明, 向明, 车正兰, 等. 彩色多普勒超声评价自体动静脉内瘘急性血栓形成中用Fogarty球囊导管取栓的临床应用. 临床超声医学杂志, 2016, 18(7): 488-490.0.
19. 徐新, 韩秋果, 刘巍立, 等. Fogarty导管取栓治疗急性肠系膜上动脉栓塞的临床疗效及安全性. 中华普通外科杂志, 2016, 31(9): 787-788.0.
20. Tall J, Björklund TC, Skogh AC, et al. Vascular complications after radiotherapy in head and neck free flap reconstruction: Clinical outcome related to vascular biology. Ann Plast Surg, 2015, 75(3): 309-315.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical application of ultrasound guided Fogarty balloon catheter in arterial crisis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content