Therapy of Thromboangitis Obliterans of Lower Extremities_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Xingsheng , LIN Ting , GUANG Yunbiao , LI Nan.

Department of Vascular Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China;

Corresponding author：

Keywords：

Lower extremity; Thromboangitis obliterans; Arterialization; Endovascular therapy; Thrombectomy

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Objective To explore the treatment of thromboangitis obliterans (TAO) of lower extremities.
Methods From March 1994 to February 2009, 24 cases (26 limbs) affected by chronic ischemia were diagnosed as TAO by Doppler ultrasound and DSA, CTA or MRA. According to the different levels of the extensive and diffuse arterial occlusion, the revascularization was performed in the ways: 19 cases (21 limbs) underwent venous arterialization, 3 cases (3 limbs) underwent endovascular therapy, and 2 cases (2 limbs) underwent thrombectomy.
Results After the venous arterialization, 19 cases (21 limbs) were followed up for 1 to 14.5 years. Apart from the 5 limbs amputation (23.8%), the postoperative results of the most limbs were satisfactory (61.9%). The ABI before therapy (0.38±0.11) was significantly lower than that 6 months after therapy (0.79±0.08), P lt;0.05. In 3 cases (3 limbs) underwent endovascular therapy, one case failed and then received the venous arterialization. Two cases (2 limbs) finished thrombectomy successfully. After endovascular therapy and thrombectomy, these 4 cases were followed up for 1 to 4 years without the amputation.
ConclusionIn order to improve the curative effect, it is important to choose the suitable therapeutic strategy according to the different levels of the extensive and diffuse arterial occlusion. The venous arterialization is an effective treatment for TAO of lower extremities.

Citation： CHEN Xingsheng,LIN Ting,GUANG Yunbiao,LI Nan.. Therapy of Thromboangitis Obliterans of Lower Extremities. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(7): 653-655. doi: Copy

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1. 赵文光, 王征, 王嘉桔, 等. 血栓闭塞性脉管炎的研究现状 [J]. 中华普通外科杂志, 2002; 17(5): 319320.
2. 王玉琦, 史振宇. 我国血管外科的现状与展望 [J]. 中国普外基础与临床杂志, 2008; 15(6): 387389.
3. Fontaine R, Buck P, Riveaux R, et al. Treatment of arterial obliterations; respective value of thrombectomies and thromboendarteriectomies, of arteriovenous shunts, and of vascular grafts (fresh venous autografts) [J]. Lyon Chir, 1951; 46(1): 7394.
4. 张华一, 徐欣. 血栓闭塞性脉管炎的近期治疗进展 [J/CD]. 中华普通外科学文献（电子版）, 2009; 3(4): 331333.
5. 谷涌泉, 齐立行, 张建, 等. 自体骨髓单个核细胞移植治疗下肢缺血的中期疗效 [J]. 中国修复重建外科杂志, 2009; 23(3): 341344.
6. 缪健航, 师天雄, 胡锡祥, 等. 自体外周血干细胞移植治疗下肢动脉缺血性疾病的临床应用 [J]. 中国普外基础与临床杂志, 2008; 15(2): 106108.
7. 蒋米尔, 陆民, 黄新天, 等. 分期静脉动脉化治疗肢体动脉广泛性闭塞的评价 [J]. 中国现代普通外科进展, 2001; 4(3): 170175.
8. 宁莫凡. 静脉动脉化治疗下肢动脉闭塞症 [J]. 临床外科杂志, 2001; 9(2): 6970.
9. 凌瑞, 易军, 宁莫凡, 等. 胫后静脉一期动脉化治疗周围动脉广泛性闭塞性疾病 [J]. 中国普外基础与临床杂志, 2007; 14(6): 694696.
10. 赵渝, 时德, 代远斌, 等. 大隐静脉动脉化治疗下肢慢性缺血88例 [J]. 中华普通外科杂志, 2006; 21(3): 187189.
11. Pokrovsky AV, Dan VN, Chupin AV, et al. Arterialization of the hand venous system in patients with critical ischemia and thrombangiitis obliterans [J]. Angiol Sosud Khir, 2007; 13(2): 105111.
12. 张培华. 静脉动脉化手术 [A]. 见: 张培华. 临床血管外科学 [M]. 北京: 人民卫生出版社, 2003: 319331.
13. 曲明, 于永山, 姜田军, 等. 动静脉转流后微循环的研究 [J]. 中华实验外科杂志, 1995; 12(6): 362363.
14. Bosiers M, Hart JP, Deloose K, et al. Endovascular therapy as the primary approach for limb salvage in patients with critical limb ischemia: experience with 443 infrapopliteal procedures [J]. Vascular, 2006; 14(2): 6369.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Therapy of Thromboangitis Obliterans of Lower Extremities

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