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急性肢体缺血患者接受治疗后随访检查时的颈动脉狭窄和腹主动脉瘤。

Carotid stenosis and abdominal aortic aneurysm at the follow-up examination in patients treated for acute extremity ischaemia.

作者信息

Kuukasjärvi P, Kaira P, Riekkinen H, Salenius J P

机构信息

Department of Surgery, Tampere University Hospital, Finland.

出版信息

J Cardiovasc Surg (Torino). 2000 Apr;41(2):275-9.

Abstract

BACKGROUND

To evaluate survivors treated for acute extremity ischaemia as a risk-group for carotid stenosis and abdominal aortic aneurysm at the follow-up examination.

EXPERIMENTAL DESIGN

Clinical study with median follow-up of 14 (8-32) months.

SETTING

Central Hospital of Central Finland.

PATIENTS

Eighteen survivors with median age of 77 (51-92) years treated for acute extremity ischaemia during two-year period intended to a separate follow-up examination median 14 (8-32) months after the acute episode of vascular occlusion. Ischaemia was considered as acute in 14 patients and acute on chronic in four patients.

INTERVENTIONS

Thromboembolectomy was the primary intervention excluding two patients with distal upper limb ischaemia who were treated by intravenous heparin.

MEASURES

Clinical examination, duplex scanning of carotid bifurcation and sonography of abdominal aorta were performed at the follow-up examination.

RESULTS

Significant asymptomatic carotid stenosis >60% was found in four patients (22%), two of these patients had significant bilateral carotid stenosis. One patient (60%) had abdominal aortic aneurysm of 5.2 cm.

CONCLUSIONS

In survivors treated for acute extremity ischaemia asymptomatic carotid stenosis >60% was found with significantly increased prevalence compared with general population and with equal prevalence when compared with patients with peripheral vascular disease. Occurrence of abdominal aortic aneurysm was parallel with findings in screening surveys.

摘要

背景

评估因急性肢体缺血接受治疗的幸存者在随访检查时作为颈动脉狭窄和腹主动脉瘤风险组的情况。

实验设计

临床研究,中位随访时间为14(8 - 32)个月。

研究地点

芬兰中部中心医院。

患者

18名幸存者,中位年龄77(51 - 92)岁,在两年期间因急性肢体缺血接受治疗,计划在血管闭塞急性发作后中位14(8 - 32)个月进行单独的随访检查。14例患者的缺血被视为急性,4例为慢性基础上的急性发作。

干预措施

血栓切除术是主要干预措施,两名上肢远端缺血患者通过静脉注射肝素治疗。

测量方法

随访检查时进行临床检查、颈动脉分叉处的双功扫描和腹主动脉超声检查。

结果

4例患者(22%)发现有大于60%的无症状性颈动脉狭窄,其中2例患者有双侧明显颈动脉狭窄。1例患者(60%)有5.2 cm的腹主动脉瘤。

结论

在因急性肢体缺血接受治疗的幸存者中,发现大于60%的无症状性颈动脉狭窄的患病率与一般人群相比显著增加,与外周血管疾病患者相比患病率相当。腹主动脉瘤的发生情况与筛查调查结果相似。

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