Bowles C R, Olcott C, Pakter R L, Lombard C, Mehigan J T, Walter J F
Department of Diagnostic Radiology, Stanford University, Palo Alto, Calif.
J Vasc Surg. 1988 Apr;7(4):487-94. doi: 10.1067/mva.1988.avs0070487.
Most complications of embolectomy with the Fogarty balloon catheter are recognized early and have received ample attention in the surgical and radiologic literature. However, the delayed complication of diffuse arterial narrowing causing severe ischemia has received little emphasis, perhaps because follow-up arteriography is not always performed. This report describes five patients--women 43 to 62 years of age--with progressive leg ischemia discovered 2 to 4 months after embolectomy with the balloon catheter. Angiography showed a characteristic pattern of severe, smooth narrowing of that portion of the artery in which balloon embolectomy was performed. Pathologic examination of arterial specimens, available in two of the five patients, revealed marked intimal cellular proliferation, which narrowed the arteries severely without evidence of thrombosis, significant atheromatosis, or active arteritis. The cause appears to be intimal damage by the balloon. Embolectomy with the balloon catheter should be done especially carefully in relatively young women.
使用Fogarty球囊导管进行取栓术的大多数并发症能被早期识别，并且在外科和放射学文献中已得到充分关注。然而，弥漫性动脉狭窄导致严重缺血的延迟并发症却很少受到重视，这可能是因为并非总是进行随访血管造影。本报告描述了5例年龄在43至62岁的女性患者，她们在使用球囊导管进行取栓术后2至4个月出现进行性腿部缺血。血管造影显示，在进行球囊取栓术的动脉部分呈现出严重、平滑狭窄的特征性模式。在这5例患者中的2例可获得动脉标本的病理检查，结果显示明显的内膜细胞增殖，严重地使动脉狭窄，而无血栓形成、显著动脉粥样硬化或活动性动脉炎的证据。病因似乎是球囊造成的内膜损伤。对于相对年轻的女性，使用球囊导管进行取栓术时应格外小心。
