Department of Cardiovascular Surgery, Dicle University, Diyarbakir, Turkey.
Eur Rev Med Pharmacol Sci. 2012 Oct;16 Suppl 4:32-4.
In infants, the most common cause of femoral artery is thrombosis and iatrogenic arterial injuries usually occur after femoral artery catheterization procedures. Management of this complication includes heparin infusion, thrombolytic agents, interventional radiologic procedures, surgical thrombectomy and by-pass surgery. Signs of arterial thrombosis developed after femoral artery catheterization procedure in the right lower extremity of 9-month-old female infant with methyl malonic acidemia. Heparin infusion was started after confirming the diagnosis of femoral artery thrombosis by ultrasonography. Because of there was no response to heparin treatment, thrombolytic therapy (t-PA) was started after 24 hours. Again, because of there was no response to all medication, surgical thrombectomy was performed. Was entered right common femoral artery with 3.0 F Fogarty catheter and fresh thrombus material was removed from the proximal and distal segments of the femoral artery. Antegrade and retrograde blood flow was achieved. After the procedure clinical signs and the symptoms of the thrombosis were resolved rapidly. There were no any complications in the postoperative period.This case encouraged us for using surgical thrombectomy in the treatment of femoral artery thrombosis in infants who do not respond to medication.
在婴儿中，股动脉最常见的原因是血栓形成，医源性动脉损伤通常发生在股动脉导管插入术之后。这种并发症的处理包括肝素输注、溶栓剂、介入放射学程序、手术血栓切除术和旁路手术。9 个月大的女性婴儿患有甲基丙二酸血症，其右侧下肢在股动脉导管插入术后出现动脉血栓形成的迹象。通过超声检查确认股动脉血栓形成的诊断后，开始输注肝素。由于肝素治疗没有反应，在 24 小时后开始溶栓治疗（t-PA）。再次，由于所有药物均无反应，进行了手术血栓切除术。使用 3.0 F Fogarty 导管进入右侧股总动脉，并从股动脉的近端和远端段取出新鲜血栓物质。实现了顺行和逆行血流。手术后，血栓形成的临床症状和体征迅速得到缓解。术后无任何并发症。这个病例鼓励我们在药物治疗无效的婴儿中使用手术血栓切除术治疗股动脉血栓形成。
