Treatment of Thromboangitis Obliterans by Embolectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GE Xiaohu , SAI Limu , LI Xuesong , REN Hao , CI Hongbo , FANG Qingbo.

Department of Vascular Surgery, People’s Hospital of Xinjiang Urgur Autonomous Region, Urumchi 830001, China;

Corresponding author：

Keywords：

Thromboangitis obliterans; Therapy; Surgery; Artery; Embolectomy

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Objective To explore the clinical experience on treatment of thromboangitis obliterans (TAO) by embolectomy. Methods Fourteen of 121 patients with TAO treated in our hospital from March 2000 to March 2010 were included in this study. Total 14 limbs consisted of 2 upper extremities and 12 lower extremities. Among these cases, 8 cases underwent embolectomy and 6 cases received embolectomy combined the stem cell transplantation.
Results Of 14 cases of TAO patients, 11 cases were successfully treated by surgery and 3 cases failed. After successful operation, patient’s pain disappeared and anklebrachial index improved obviously. Seven patients treated successfully by surgery were followed up from 5 months to 8.5 years (mean 4 years), in whom the intermittent claudication and rest pain disappeared in 4 cases, and disease deteriorated in 2 cases who always smoked, and one case had intermittent claudication who stopped smoking. For 3 cases patients failed to operation, one lost followup, one had to receive a below knee amputation due to keep smoking after operation, and one case who stopped smoking underwent alleviative symptoms for 3 years.
Conclusion Embolectomy is a safe and effective technique for treating TAO.

Citation： GE Xiaohu,SAI Limu,LI Xuesong,REN Hao,CI Hongbo,FANG Qingbo.. Treatment of Thromboangitis Obliterans by Embolectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(7): 672-675. doi: Copy

1.	Buerger L. Thromboangiitis obliterans: a study of the vascular lesions leading to presenile spontaneous gangrene [J]. Am J Med Sci, 1908; 136: 567580.
2.	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.
3.	Shionoya S. Buerger’s Disease (thromboangiitis obliterans) [A]. In: Rutherford RB. Vascular Surgery [M]. 4th ed. Philadelphia: WB Saunders, 1994: 235245.
4.	Fujii Y, Soga J, Nakamura S, et al. Classification of Corkscrew Collaterals in Thromboangiitis Obliterans (Buerger’s Disease) [J]. Circ J, 2010; 9(6): 11781183.
5.	Piazza G, Creager MA. Thromboangiitis obliterans [J]. Circulation, 2010; 121(16): 18581861.
6.	Espinoza LR. Buerger’s disease: thromboangiitis obliterans 100 years after the initial description [J]. Am J Med Sci, 2009; 337(4): 285286.
7.	Abyshov NS, Zakirdzhaev EA, Aliev ZM. Modern aspects of diagnostics and treatment for thromboangiitis obliterans [J]. Khirurgiia (Mosk), 2009; (2): 7579.
8.	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.
9.	Ohta T, Ishioashi H, Hosaka M, et al. Clinical and social consequences of Buerger disease [J]. J Vasc Surg, 2004; 39(1): 176180.
10.	胡骥琼,　王道明, 司春强, 等. 下肢动脉粥样硬化闭塞症截肢残体的血管解剖及临床意义 [J]. 中国普外基础与临床杂志, 2008; 15(6): 412415.
11.	Zatevakhin II, Govorunov GV, Dobronravov DS, et al. Transplantation of the greater omentum using microsurgical technics in thromboangiitis obliterans [J]. Khirurgiia (Mosk), 1984; (5): 6166.
12.	Vachev AN, Mikhaǐlov MS, Novozhilov AV. Microsurgical autotransplantation of the greater omentum to a lower limb in patients with critical ischaemia accompanying thromboangiitis obliterans [J]. Angiol Sosud Khir, 2008; 14(3): 107110.
13.	Gordon A, Zechmeister K, Collin J. The role of sympathectomy in current surgical practice [J]. Eur J Vasc Surg, 1994; 8(2): 129137.
14.	马震寰, 杨镛, 杨国凯, 等. 下肢动脉硬化闭塞症继发血栓形成治疗分析 [J]. 中国普外基础与临床杂志, 2010; 17(3): 275277.
15.	Perlat A, Decaux O, Jégo P. Limb pain and pain in extremities. Diagnosis orientation [J]. Rev Prat, 2008; 58(16): 18211827.
16.	马中, 边杰芳, 袁时芳, 等. 一期动静脉转流术在广泛性下肢动脉缺血循环重建中的应用 [J]. 中国修复重建外科杂志, 2006; 20(12): 11681171.
17.	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.
18.	薛莲, 张培华. 血栓闭塞性脉管炎研究现况 [J]. 中华普通外科杂志, 1997; 12(5): 265266.
19.	Sapoval MR, Long AL, Raynaud AC, et al. Femoropliteal stent placement longterm results [J]. Radiology, 1992; 184(3): 833839.
20.	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.
21.	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.
22.	Kajiguchi M, Kondo T, Izawa H, et al. Safety and efficacy of autologous progenitor cell transplantation for therapeutic angiogenesis in patients with critical limb ischemia [J]. Circ J, 2007; 71(2): 196201.
23.	Saito Y, Sasaki K, Katsuda Y, et al. Effect of autologous bone marrow cell transplantation on ischemic ulcer in patients with Buerger’s disease [J]. Circ J, 2007; 71(8): 11871192.
24.	李雪松, 戈小虎, 赛力木, 等. 急性肢体动脉栓塞手术治疗（附47例报告） [J]. 中国普外基础与临床杂志, 2004; 11(2): 118.
25.	戈小虎, 管圣. 急性下肢动脉栓塞的诊断及治疗要点 [J]. 外科理论与实践, 2009; 14(3): 274277.

1. Buerger L. Thromboangiitis obliterans: a study of the vascular lesions leading to presenile spontaneous gangrene [J]. Am J Med Sci, 1908; 136: 567580.
2. 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.
3. Shionoya S. Buerger’s Disease (thromboangiitis obliterans) [A]. In: Rutherford RB. Vascular Surgery [M]. 4th ed. Philadelphia: WB Saunders, 1994: 235245.
4. Fujii Y, Soga J, Nakamura S, et al. Classification of Corkscrew Collaterals in Thromboangiitis Obliterans (Buerger’s Disease) [J]. Circ J, 2010; 9(6): 11781183.
5. Piazza G, Creager MA. Thromboangiitis obliterans [J]. Circulation, 2010; 121(16): 18581861.
6. Espinoza LR. Buerger’s disease: thromboangiitis obliterans 100 years after the initial description [J]. Am J Med Sci, 2009; 337(4): 285286.
7. Abyshov NS, Zakirdzhaev EA, Aliev ZM. Modern aspects of diagnostics and treatment for thromboangiitis obliterans [J]. Khirurgiia (Mosk), 2009; (2): 7579.
8. 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.
9. Ohta T, Ishioashi H, Hosaka M, et al. Clinical and social consequences of Buerger disease [J]. J Vasc Surg, 2004; 39(1): 176180.
10. 胡骥琼,　王道明, 司春强, 等. 下肢动脉粥样硬化闭塞症截肢残体的血管解剖及临床意义 [J]. 中国普外基础与临床杂志, 2008; 15(6): 412415.
11. Zatevakhin II, Govorunov GV, Dobronravov DS, et al. Transplantation of the greater omentum using microsurgical technics in thromboangiitis obliterans [J]. Khirurgiia (Mosk), 1984; (5): 6166.
12. Vachev AN, Mikhaǐlov MS, Novozhilov AV. Microsurgical autotransplantation of the greater omentum to a lower limb in patients with critical ischaemia accompanying thromboangiitis obliterans [J]. Angiol Sosud Khir, 2008; 14(3): 107110.
13. Gordon A, Zechmeister K, Collin J. The role of sympathectomy in current surgical practice [J]. Eur J Vasc Surg, 1994; 8(2): 129137.
14. 马震寰, 杨镛, 杨国凯, 等. 下肢动脉硬化闭塞症继发血栓形成治疗分析 [J]. 中国普外基础与临床杂志, 2010; 17(3): 275277.
15. Perlat A, Decaux O, Jégo P. Limb pain and pain in extremities. Diagnosis orientation [J]. Rev Prat, 2008; 58(16): 18211827.
16. 马中, 边杰芳, 袁时芳, 等. 一期动静脉转流术在广泛性下肢动脉缺血循环重建中的应用 [J]. 中国修复重建外科杂志, 2006; 20(12): 11681171.
17. 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.
18. 薛莲, 张培华. 血栓闭塞性脉管炎研究现况 [J]. 中华普通外科杂志, 1997; 12(5): 265266.
19. Sapoval MR, Long AL, Raynaud AC, et al. Femoropliteal stent placement longterm results [J]. Radiology, 1992; 184(3): 833839.
20. 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.
21. 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.
22. Kajiguchi M, Kondo T, Izawa H, et al. Safety and efficacy of autologous progenitor cell transplantation for therapeutic angiogenesis in patients with critical limb ischemia [J]. Circ J, 2007; 71(2): 196201.
23. Saito Y, Sasaki K, Katsuda Y, et al. Effect of autologous bone marrow cell transplantation on ischemic ulcer in patients with Buerger’s disease [J]. Circ J, 2007; 71(8): 11871192.
24. 李雪松, 戈小虎, 赛力木, 等. 急性肢体动脉栓塞手术治疗（附47例报告） [J]. 中国普外基础与临床杂志, 2004; 11(2): 118.
25. 戈小虎, 管圣. 急性下肢动脉栓塞的诊断及治疗要点 [J]. 外科理论与实践, 2009; 14(3): 274277.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Treatment of Thromboangitis Obliterans by Embolectomy

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