The Effect of Fogarty Catheter Embolectomy Combined with Multiple Minimally Invasive Techniques for Acute Limb Ischemia_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIGuo-jian ,  YANGYong , YANGGuo-kai , WANJia , MAZhen-huan , LUPing , DULing-juan

Department of Vascular Surgery, Secondary People's Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China;

Corresponding author：

YANGYong, Email: yncvs126@126.com

Keywords：

Fogarty catheter embolectomy; Minimally invasive surgery; Acute limb ischemia; Interventional procedure

DOI：

10.7507/1007-9424.20140165

Video：

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Objective To investigate the significance of Fogarty catheter embolectomy combined with multiple minimally invasive techniques for acute limb ischemia. Methods Clinical data of 88 cases(88 limbs) of lower limb ischemia who were treated in our hospital from Feb. 2007 to Jan. 2011 were collected and analyzed. Of the 88 patients, 46 cases were operated by Fogarty catheter embolectomy(embolectomy group), 42 cases were operated by Fogarty catheter embolectomy combined with multiple minimally invasive techniques(combination group). Comparisons of the clinical indexes of ankle-brachial index(ABI), saturation of blood oxygen(SO₂) of toes, and temperature of foot skin before and after operation were performed between the 2 groups, as well as the incidence of mortality, complication, and amputation after operation. Results Compared with before operation in the same group, the value of ABI, SO₂, and temperature of foot skin in the 2 groups were higher(P<0.05), as well as the 3 kinds of indexes were both higher in combination group after operation(P<0.05). The rates of mortality, amputation, myonephropathic metabolic syndrome(MNMS), osteofascial compartment syndrome, and transient renal insufficiency were 13.04%(6/46), 17.39%(8/46), 26.09% (12/46), 26.09%(12/46), and 13.04%(6/46) respectively, the corresponding rates in combination group were 4.76% (2/42), 7.14%(3/42), 14.29%(6/42), 9.52%(4/42), and 9.52%(4/42) respectively, which were all lower in combination group(P<0.05). Conclusion Fogarty catheter embolectomy combined with multiple minimally invasive techniques can be one of the surgical treatment methods for acute limb ischemia, which is characterized by minimally invasive surgery and effective treatment.

Citation： LIGuo-jian, YANGYong, YANGGuo-kai, WANJia, MAZhen-huan, LUPing, DULing-juan. The Effect of Fogarty Catheter Embolectomy Combined with Multiple Minimally Invasive Techniques for Acute Limb Ischemia. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(6): 688-692. doi: 10.7507/1007-9424.20140165 Copy

1.	Creager MA, Dzau VJ, Loscalzo J著.王宏宇,龚兰生,胡大一译.血管医学[M].北京:北京大学医学出版社, 2009:683-685.
2.	卢勇,郑月宏,刘昌伟.我国急性下肢缺血外科治疗现状分析[J].临床外科杂志, 2011, 19(5):302-307.
3.	Katzen BT.Clinical diagnosis and prognosis of acute limb ischemia[J].Rev Cardiovasc Med, 2002, 3 Suppl 2:S2-S6.
4.	卡维,殷恒讳,姚陈,等.急性下肢动脉缺血的临床研究[J/CD].中国血管外科杂志:电子版, 2011, 3(4):218-221.
5.	车海杰,杨牟,张居文,等.DSA下动脉取栓与传统的动脉取栓手术效果的比较研究[J].中国医师杂志, 2011, z1:7-10.
6.	李国剑,杨镛,杨国凯,等.自体外周血干细胞移植治疗血栓闭塞性脉管炎的临床应用[J].中国普外基础与临床杂志, 2012, 19(11):1187-1190.
7.	沈海刚,王雄.踝肱指数在下肢动脉缺血性疾病诊治中的应用[J].浙江中西医结合杂志, 2012, 22(6):472-473.
8.	Schumann R, Rieger J, Ludwig M.Acute peripheral arterial occlusive disease[J].Med Klin (Munich), 2007, 102(6):457-471.
9.	汪忠镐,张建,谷涌泉.实用血管外科与血管介入治疗学[M].北京:人民军医出版社, 2004:241-246.
10.	杨镛,王深明,徐克.微创血管外科学[M].北京:科学出版社, 2011:121-139.
11.	车海杰,杨牟,张居文,等.下肢急性动脉栓塞DSA下取栓116例临床分析[J].中国老年学杂志, 2011, 31(9):1657-1658.
12.	李国剑,杨国凯,何晓明,等.下肢急性动脉缺血的治疗及并发症的防治[J].中华临床医学实践杂志, 2009, 8(3):165-166.
13.	张文婧,宋冰,侯澎,等.急性下肢动脉缺血再灌注损伤的机制和防治[J].中国民族民间医药, 2009, 18(z1):146-147.
14.	万嘉,杨镛,时德,等.重症肢体缺血致肌病肾病代谢综合征25例[J].临床医学, 2009, 29(4):32-33.
15.	慈红波,戈小虎,刘杰,等.急性动脉栓塞致肌病肾病代谢综合征诊断与治疗[J].国际外科学杂志, 2009, 36(10):655-657.
16.	郭曙光,周兴立,方伟,等.DSA监视下急性下肢缺血的介入联合手术治疗[J].中华普通外科杂志, 2007, 22(4):288-290.
17.	李宴节,赵增富,崔进国,等.介入技术在下肢急性动脉栓塞中的应用[J].临床误诊误治, 2011, 24(6):59-61.
18.	Ouriel K, Shortell CK, DeWeese JA, et al.A comparison of thrombolytic therapy with operative revascularization in the initial treatment of acute peripheral arterial ischemia[J].J Vasc Surg, 1994, 19(6):1021-1030.
19.	Ouriel K, Veith FJ, Sasahara AA, et al.A comparison of recombinant urokinase with vascular surgery as initial treatment for acute arterial occlusion of the legs.Thrombolysis or Peripheral Arterial Surgery (TOPAS) Investigators[J].N Engl J Med, 1998, 338(16):1105-1111.
20.	张磊,王静砉,李彦辉,等.手术联合介入治疗合并动脉硬化的急性下肢动脉栓塞临床观察[J].河北医学, 2008, 14(11):1320-1322.
21.	娄尧强,徐侃,王林君,等.置管溶栓术在下肢急性动脉栓塞治疗中的应用[J].浙江创伤外科, 2011, 16(1):89-91.
22.	李城,王峰,纪东华,等.急性下肢动脉栓塞介入综合治疗临床应用[J].当代医学, 2011, 17(14):8-9.
23.	闫瑞强,何俊峰,李启民.急性下肢动脉血栓栓塞介入综合治疗的分析[J].中外医疗, 2012, 31(12):122, 128.
24.	厉建林.杂交手术治疗下肢急性动脉栓塞的策略[J].中国普通外科杂志, 2013, 22(6):762-765.
25.	Casserly IP, Sachar R, Yadav JS.Practical peripheral vascular intervention[M].Lippincott:Williams&Wilkins, 2011:194-217.

1. Creager MA, Dzau VJ, Loscalzo J著.王宏宇,龚兰生,胡大一译.血管医学[M].北京:北京大学医学出版社, 2009:683-685.
2. 卢勇,郑月宏,刘昌伟.我国急性下肢缺血外科治疗现状分析[J].临床外科杂志, 2011, 19(5):302-307.
3. Katzen BT.Clinical diagnosis and prognosis of acute limb ischemia[J].Rev Cardiovasc Med, 2002, 3 Suppl 2:S2-S6.
4. 卡维,殷恒讳,姚陈,等.急性下肢动脉缺血的临床研究[J/CD].中国血管外科杂志:电子版, 2011, 3(4):218-221.
5. 车海杰,杨牟,张居文,等.DSA下动脉取栓与传统的动脉取栓手术效果的比较研究[J].中国医师杂志, 2011, z1:7-10.
6. 李国剑,杨镛,杨国凯,等.自体外周血干细胞移植治疗血栓闭塞性脉管炎的临床应用[J].中国普外基础与临床杂志, 2012, 19(11):1187-1190.
7. 沈海刚,王雄.踝肱指数在下肢动脉缺血性疾病诊治中的应用[J].浙江中西医结合杂志, 2012, 22(6):472-473.
8. Schumann R, Rieger J, Ludwig M.Acute peripheral arterial occlusive disease[J].Med Klin (Munich), 2007, 102(6):457-471.
9. 汪忠镐,张建,谷涌泉.实用血管外科与血管介入治疗学[M].北京:人民军医出版社, 2004:241-246.
10. 杨镛,王深明,徐克.微创血管外科学[M].北京:科学出版社, 2011:121-139.
11. 车海杰,杨牟,张居文,等.下肢急性动脉栓塞DSA下取栓116例临床分析[J].中国老年学杂志, 2011, 31(9):1657-1658.
12. 李国剑,杨国凯,何晓明,等.下肢急性动脉缺血的治疗及并发症的防治[J].中华临床医学实践杂志, 2009, 8(3):165-166.
13. 张文婧,宋冰,侯澎,等.急性下肢动脉缺血再灌注损伤的机制和防治[J].中国民族民间医药, 2009, 18(z1):146-147.
14. 万嘉,杨镛,时德,等.重症肢体缺血致肌病肾病代谢综合征25例[J].临床医学, 2009, 29(4):32-33.
15. 慈红波,戈小虎,刘杰,等.急性动脉栓塞致肌病肾病代谢综合征诊断与治疗[J].国际外科学杂志, 2009, 36(10):655-657.
16. 郭曙光,周兴立,方伟,等.DSA监视下急性下肢缺血的介入联合手术治疗[J].中华普通外科杂志, 2007, 22(4):288-290.
17. 李宴节,赵增富,崔进国,等.介入技术在下肢急性动脉栓塞中的应用[J].临床误诊误治, 2011, 24(6):59-61.
18. Ouriel K, Shortell CK, DeWeese JA, et al.A comparison of thrombolytic therapy with operative revascularization in the initial treatment of acute peripheral arterial ischemia[J].J Vasc Surg, 1994, 19(6):1021-1030.
19. Ouriel K, Veith FJ, Sasahara AA, et al.A comparison of recombinant urokinase with vascular surgery as initial treatment for acute arterial occlusion of the legs.Thrombolysis or Peripheral Arterial Surgery (TOPAS) Investigators[J].N Engl J Med, 1998, 338(16):1105-1111.
20. 张磊,王静砉,李彦辉,等.手术联合介入治疗合并动脉硬化的急性下肢动脉栓塞临床观察[J].河北医学, 2008, 14(11):1320-1322.
21. 娄尧强,徐侃,王林君,等.置管溶栓术在下肢急性动脉栓塞治疗中的应用[J].浙江创伤外科, 2011, 16(1):89-91.
22. 李城,王峰,纪东华,等.急性下肢动脉栓塞介入综合治疗临床应用[J].当代医学, 2011, 17(14):8-9.
23. 闫瑞强,何俊峰,李启民.急性下肢动脉血栓栓塞介入综合治疗的分析[J].中外医疗, 2012, 31(12):122, 128.
24. 厉建林.杂交手术治疗下肢急性动脉栓塞的策略[J].中国普通外科杂志, 2013, 22(6):762-765.
25. Casserly IP, Sachar R, Yadav JS.Practical peripheral vascular intervention[M].Lippincott:Williams&Wilkins, 2011:194-217.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Effect of Fogarty Catheter Embolectomy Combined with Multiple Minimally Invasive Techniques for Acute Limb Ischemia

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