Magishi Katsuaki, Izumi Yuichi, Shimizu Noriyuki
Deparment of Cardiovascular Surgery, Nayoro City General Hospital, Hokkaido, Nayoro, Japan.
Ann Thorac Cardiovasc Surg. 2010 Aug;16(1):31-4.
To evaluate the short-/long-term outcomes after acute thromboembolism of the upper extremity.
Twenty-one patients with acute arterial occlusion in the upper extremity were treated from January 1993 to July 2007 at our hospital. Their average age was 73.0, and 14 (66%) were male. The right and left limbs were affected in 15 cases (71%) and 6 cases (29%), respectively. The main associated disease was arrhythmia, in 20 cases (95%), including atrial fibrillation in 17 (81%). The time from onset to operation was 9.7 +/- 9.2 h (range: 2-41 h). All patients underwent thromboembolectomy with a Fogarty catheter.
The symptoms showed regression in all cases after operation, but one patient died from cerebral infarction the following day. Anticoagulant and antiplatelet therapies are commonly prescribed in cases after thromboembolectomy. The free rates of thromboembolism were 74% and 27%, and cumulative actuarial survival rates were 95% and 61% at 1 and 3 years, respectively.
Because of the high recurrence rates of thromboembolism, it seems necessary to severe anticoagulant therapy. Upper extremity thromboembolism should also be considered as one manifestation of a systemic embolism.
评估上肢急性血栓栓塞后的短期/长期预后。
1993年1月至2007年7月，我院共治疗21例上肢急性动脉闭塞患者。他们的平均年龄为73.0岁，男性14例（66%）。右上肢和左上肢受累分别为15例（71%）和6例（29%）。主要相关疾病为心律失常，共20例（95%），其中17例（81%）为心房颤动。从发病到手术的时间为9.7±9.2小时（范围：2 - 41小时）。所有患者均采用Fogarty导管进行血栓切除术。
术后所有病例症状均有缓解，但1例患者术后次日死于脑梗死。血栓切除术后通常会进行抗凝和抗血小板治疗。血栓栓塞的游离率分别为74%和27%，1年和3年的累积精算生存率分别为95%和61%。
由于血栓栓塞的复发率较高，似乎有必要进行强化抗凝治疗。上肢血栓栓塞也应被视为全身性栓塞的一种表现。
