Miyake Keisuke, Kikuchi Shinsuke, Kitani Yuya, Koya Atsuhiro, Takeuchi Toshiharu, Hasebe Naoyuki, Sawa Yoshiki, Azuma Nobuyoshi
Department of Vascular Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Ann Vasc Dis. 2018 Sep 25;11(3):361-364. doi: 10.3400/avd.cr.18-00059.
Acute limb ischemia (ALI) is associated with high morbidity and mortality rates, even with the advent of technical advances. Although myocardial infarction is one of the causes of ALI along with intraventricular thrombus formation and subsequent embolism, ALI with concomitant acute myocardial infarction (AMI) is extremely rare. Here, we report a complicated ALI case with concurrent AMI and prolonged limb ischemic duration. The cause may be attributed to thrombosis with atherosclerotic disease of the coronary and peripheral arteries triggered by dehydration. We successfully treated the patient using simultaneous revascularization in a hybrid operating room with the aid of intraoperative hemodialysis for preventing life-threatening reperfusion syndrome.
急性肢体缺血(ALI)即使在技术进步的情况下,仍与高发病率和死亡率相关。虽然心肌梗死是ALI的病因之一,与心室内血栓形成及随后的栓塞一样,但合并急性心肌梗死(AMI)的ALI极为罕见。在此,我们报告一例并发AMI且肢体缺血持续时间延长的复杂ALI病例。病因可能归因于脱水引发的冠状动脉和外周动脉粥样硬化疾病伴发的血栓形成。我们在杂交手术室通过同时进行血运重建,并借助术中血液透析成功治疗了该患者,以预防危及生命的再灌注综合征。