Department of Radiology, Busan National University Hospital, Busan, South Korea.
Eur J Vasc Endovasc Surg. 2010 Jan;39(1):89-96. doi: 10.1016/j.ejvs.2009.09.023. Epub 2009 Nov 10.
To assess the efficacy of stent-assisted recanalisation for acute limb ischaemia in patients considered unfit for thrombolysis or in patients with failed surgical recanalisation.
Fifteen patients with acute limb ischaemia, treated with stent implantation, were analysed retrospectively. The reasons for acute limb ischaemia were a cardiogenic embolism (n=3), a traumatic injury (n=3), acute in situ thrombosis with atherosclerosis (n=6), immediate graft thrombosis (n=2), or a delayed thrombotic occlusion after a thrombin injection in the pseudoaneurysm (n=1). This study examined the technical and clinical outcomes of the procedures, including complications during the procedural and follow-up periods.
Stent-assisted recanalisation was technically successful and provided immediate recanalisation in all patients (15/15 patients, 100%) and reduced or eliminated the clinical symptoms in 12 patients (12/15 patients, 80%). Two patients died of multi-organ failure related to reperfusion injury, and one patient with a crash injury underwent a below-the-knee amputation as a result of wound necrosis despite recanalisation of the occluded bypass graft.
Stent-assisted recanalisation has a high technical success rate with good clinical results as a bailout procedure for the management of acute limb ischaemia in patients, considered unfit for thrombolysis or in patients with failed surgical recanalisation.
评估支架辅助再通术治疗不适合溶栓或手术再通失败的急性肢体缺血患者的疗效。
回顾性分析 15 例接受支架植入治疗的急性肢体缺血患者。急性肢体缺血的原因包括心源性栓塞（n=3）、创伤性损伤（n=3）、伴动脉粥样硬化的急性原位血栓形成（n=6）、即刻移植血管血栓形成（n=2）或假性动脉瘤内凝血酶注射后延迟性血栓闭塞（n=1）。本研究分析了手术的技术和临床结果，包括手术期间和随访期间的并发症。
支架辅助再通术在技术上是成功的，所有患者（15/15 例，100%）均立即再通，并使 12 例（12/15 例，80%）患者的临床症状减轻或消除。2 例患者因再灌注损伤相关多器官衰竭而死亡，1 例创伤性损伤患者尽管闭塞旁路移植血管再通，但因伤口坏死而行膝下截肢。
支架辅助再通术作为溶栓或手术再通失败的补救治疗方法，治疗不适合溶栓或手术再通失败的急性肢体缺血患者，具有较高的技术成功率和良好的临床效果。
