Karanam Lakshmi Sudha Prasanna, Busireddy Narendra Reddy, Baddam Sridhar Reddy, Makineni Kiran, Paidimukkala Vijaya, Raghavasarma P
Lalitha Super Speciality Hospitals, Guntur, Andhra Pradesh, India.
BMR Hospitals, Guntur, India.
J Clin Orthop Trauma. 2018 Apr-Jun;9(2):121-124. doi: 10.1016/j.jcot.2016.12.010. Epub 2017 Jan 6.
Acute arterial occlusions after total knee arthroplasty (TKA) are rare but very serious complication. We present a series of 9 patients who underwent endovascular recanalisation for acute thrombotic occlusion following TKA in our institution. The present series determine the importance of early diagnosis and role of early intervention for good clinical outcome in these cases.
From 2013 to 2016, a total of 9 patients (3 male and 6 female) presented with acute popliteal thrombosis following TKA. All the patients underwent endovascular procedure. Clinical presentation, procedural details and clinical outcome was discussed.
Technical success is achieved in all the cases. A combination of clot lysis, thromboaspiration and balloon angioplasty was used. 8 patients had successful clinical outcome. One patient underwent amputation despite good recanalisation.
High degree suspicion with careful monitoring in the postoperative period is needed to identify the problem at the earliest, and early diagnosis with recanalisation within 6 h is the key to limb salvage in these patients.
全膝关节置换术(TKA)后急性动脉闭塞是一种罕见但非常严重的并发症。我们报告了本院9例因TKA后急性血栓形成闭塞而接受血管内再通治疗的患者。本系列病例确定了早期诊断的重要性以及早期干预对这些病例良好临床结局的作用。
2013年至2016年,共有9例患者(3例男性,6例女性)在TKA后出现急性腘静脉血栓形成。所有患者均接受了血管内手术。讨论了临床表现、手术细节和临床结局。
所有病例均取得技术成功。采用了溶栓、血栓抽吸和球囊血管成形术相结合的方法。8例患者临床结局良好。1例患者尽管再通效果良好仍接受了截肢手术。
术后需要高度怀疑并仔细监测,以便尽早发现问题,而在6小时内进行早期诊断并再通是挽救这些患者肢体的关键。