Littooy F N, Baker W H
J Vasc Surg. 1986 Sep;4(3):211-6.
Eighteen patients whose mean age was 61 years were referred to us with acute aortic occlusion from 1977 to 1985. Ten patients had cardiac emboli (group I) and eight had aortoiliac occlusive disease (group II). Fourteen of these patients had paresis or paralysis. Diagnosis was prompt but the time lapse from onset of symptoms to revascularization averaged 18 hours (group I, 10.3 hours; group II, 26.1 hours). All 10 patients in group I had embolectomy alone; of the eight patients in group II, two had transfemoral thrombectomy and six had bypass procedures. The perioperative mortality rate was 40% in group I and 62.5% in group II. Complications developed in 12 patients (nine died); renal failure occurred in 11, compartment syndrome in nine, adult respiratory disease syndrome in three, acute myocardial infarction in three, disseminated intravascular coagulation in two, and paraplegia in one. No amputations were required in the nine survivors and limb function was restored in eight of these patients. Acute aortic occlusion sets in motion a chain of events that threatens life and limb. Prompt diagnosis and revascularization by the simplest operation are required to decrease morbidity and mortality.
1977年至1985年间，18名平均年龄为61岁的患者因急性主动脉闭塞被转诊至我院。其中10名患者有心脏栓子（I组），8名有主-髂动脉闭塞性疾病（II组）。这些患者中有14名出现轻瘫或瘫痪。诊断迅速，但从症状出现到血管再通的时间平均为18小时（I组为10.3小时；II组为26.1小时）。I组的所有10名患者仅接受了栓子切除术；II组的8名患者中，2名接受了经股动脉血栓切除术，6名接受了搭桥手术。I组围手术期死亡率为40%，II组为62.5%。12名患者出现并发症（9名死亡）；11名发生肾衰竭，9名发生骨筋膜室综合征，3名发生成人呼吸窘迫综合征，3名发生急性心肌梗死，2名发生弥散性血管内凝血，1名发生截瘫。9名幸存者均无需截肢，其中8名患者肢体功能得以恢复。急性主动脉闭塞引发一系列危及生命和肢体的事件。需要通过最简单的手术进行迅速诊断和血管再通，以降低发病率和死亡率。
