Miroslav Marković, Lazar Davidović, Aleksandar Mikić, Predrag Djorić, Svetozar Putnik
Institute for Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia and Montenegro.
Vascular. 2005 Jul-Aug;13(4):222-9. doi: 10.1258/rsmvasc.13.4.222.
The purpose of this study was to present 11 patients operated on owing to rare forms of peripheral arterial embolism at the Institute for Cardiovascular Diseases of the Serbian Clinical Center over a period of 20 years. Three patients were operated on owing to a foreign body embolism, two owing to a septic embolism, three owing to emboli that originated from malignant tissues, two owing to an embolization from cardiac myxoma, and one owing to an embolism from a myxomatous atrial septal defect. The preoperative evaluation included clinical examination, laboratory findings, and electrocardiography; in the majority of cases, ultrasonography and angiography were performed. Surgical treatment included foreign body extraction in three cases; thromboembolectomy in seven cases, and artery resection and saphenous graft interposition in one patient with septic embolism. In addition, three cardiosurgical procedures were done: aortic valve replacement in the patient with a septic embolism and tumor excision in patients with atrial myxoma. In addition to the usual clinical signs of acute limb ischemia, in the rare forms of arterial embolism, the presence of certain uncommon clinical symptoms was also observed. The early results of vascular surgical treatment were very good in all patients. Further follow-up revealed a poor prognosis in patients with malignant arterial embolism.
本研究的目的是介绍塞尔维亚临床中心心血管疾病研究所20年间因罕见类型的外周动脉栓塞而接受手术的11例患者。3例患者因异物栓塞接受手术，2例因脓毒性栓塞，3例因源自恶性组织的栓子，2例因心脏黏液瘤引起的栓塞，1例因黏液瘤性房间隔缺损引起的栓塞。术前评估包括临床检查、实验室检查结果和心电图检查；大多数病例还进行了超声检查和血管造影。手术治疗包括3例异物取出术；7例血栓切除术，1例脓毒性栓塞患者行动脉切除及大隐静脉移植术。此外，还进行了3例心脏外科手术：1例脓毒性栓塞患者行主动脉瓣置换术，心房黏液瘤患者行肿瘤切除术。除了急性肢体缺血的常见临床体征外，在罕见类型的动脉栓塞中，还观察到某些不常见的临床症状。所有患者血管外科治疗的早期结果都非常好。进一步随访发现，恶性动脉栓塞患者预后较差。
