Jiang Bu-Ping, Cheng Guo-Bing, Hu Qiang, Wu Jia-Wen, Li Xiao-Yang, Liao Sheng, Wu Sen-Yan, Lu Wei
Department of Vascular Surgery, People's Hospital of Quzhou, Quzhou 324000, Zhejiang Province, China.
World J Clin Cases. 2020 Dec 26;8(24):6473-6479. doi: 10.12998/wjcc.v8.i24.6473.
Acute arterial embolism of the extremities is a surgical emergency. Atrial fibrillation is the major etiology of acute arterial embolism of the extremities. Emergency femoral artery thrombectomy can successfully treat this issue. However, polycythemia vera (PV) may sometimes explain this medical emergency. Recurrent thrombosis in the lower extremities after thrombectomy can be found in patients with PV, and reoperation is needed for this condition.
A 68-year-old man in China suffered from sudden pain in the left lower extremity for 14 h. The examination in the emergency department showed a diagnosis of acute arterial embolism of the extremities combined with PV. The patient's complaint disappeared after repeat emergency thrombectomy.
Patients with acute arterial embolism of the extremities should be treated carefully, especially those who have recurrent thrombosis after emergency thrombectomy. Clinicians should be aware of PV, a rare cause of acute arterial embolism of the extremities. The combination of thrombectomy, phlebotomy, and antiplatelet and anticoagulant drugs may be a suitable therapeutic regimen for these patients.
肢体急性动脉栓塞是一种外科急症。心房颤动是肢体急性动脉栓塞的主要病因。急诊股动脉血栓切除术可成功治疗这一问题。然而，真性红细胞增多症（PV）有时也可解释这一医疗急症。PV患者在血栓切除术后下肢可能出现复发性血栓形成，对此情况需要再次手术。
一名68岁中国男性，左下肢突发疼痛14小时。急诊科检查显示诊断为肢体急性动脉栓塞合并PV。经再次急诊血栓切除术后患者的症状消失。
肢体急性动脉栓塞患者应谨慎治疗，尤其是那些在急诊血栓切除术后出现复发性血栓形成的患者。临床医生应意识到PV这种肢体急性动脉栓塞的罕见病因。血栓切除术、放血疗法以及抗血小板和抗凝药物联合使用可能是这些患者合适的治疗方案。
