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使用普鲁伊特-F3颈动脉分流管进行临时性血管内分流治疗创伤性腘动脉损伤

Temporary Intravascular Shunting Using a Pruitt-F3 Carotid Shunt for Traumatic Popliteal Artery Injury.

作者信息

Izawa Yuta, Murakami Hiroko, Sato Kazuo, Minegishi Mizuki, Tsuchida Yoshihiko

机构信息

From the Department of Orthopaedic Trauma Center, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido, Japan.

出版信息

Plast Reconstr Surg Glob Open. 2024 Jul 17;12(7):e5980. doi: 10.1097/GOX.0000000000005980. eCollection 2024 Jul.

Abstract

Temporary intravascular shunting (TIVS) is an effective method to shorten the duration of ischemia and contribute to limb salvage in the treatment of popliteal artery injury (PAI). Traditionally used shunt tubes require ligation or clamping to the blood vessel, which has the disadvantage of causing secondary damage to the vessel. We present two cases in which TIVS was performed using the Pruitt-F3 Carotid Shunt (LeMaitre Vascular Inc., Burlington, Mass.) for traumatic PAI and report the effectiveness of the method. Two patients diagnosed with PAI had pallor of the feet and complete motor and sensory paralysis. The patients were immediately transferred to the operating room. PAI was confirmed in one patient by the medial approach and in the other by the posterior approach. In both patients, the vascular injury extended to the vicinity of the bifurcation into the anterior tibial artery. TIVS was performed using a 9Fr Pruitt-F3 Carotid Shunt. In both patients, the color tone of the feet improved. No vascular damage occurred secondary to TIVS. The popliteal artery was reconstructed using a great saphenous vein graft on the contralateral lower extremity, and the limb was salvaged. If the artery is injured near its bifurcation, it may be possible to preserve the branch vessel by using the Pruitt-F3 Carotid Shunt for TIVS.

摘要

临时血管内分流术(TIVS)是一种有效缩短缺血时间并有助于在腘动脉损伤(PAI)治疗中挽救肢体的方法。传统使用的分流管需要对血管进行结扎或钳夹,这具有对血管造成继发性损伤的缺点。我们报告两例使用普鲁伊特-F3颈动脉分流管(LeMaitre Vascular Inc.,马萨诸塞州伯灵顿)进行TIVS治疗创伤性PAI的病例,并报告该方法的有效性。两名被诊断为PAI的患者足部苍白,伴有完全性运动和感觉麻痹。患者立即被送往手术室。其中一名患者通过内侧入路确诊PAI,另一名通过后入路确诊。两名患者的血管损伤均延伸至胫前动脉分叉附近。使用9Fr普鲁伊特-F3颈动脉分流管进行TIVS。两名患者足部的色泽均得到改善。未发生TIVS继发的血管损伤。使用对侧下肢的大隐静脉移植物重建腘动脉,肢体得以挽救。如果动脉在其分叉附近受损,使用普鲁伊特-F3颈动脉分流管进行TIVS可能能够保留分支血管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06d7/11254107/c80cec1b79fc/gox-12-e5980-g001.jpg

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