Starr D S, Lawrie G M, Morris G C
Am J Surg. 1979 Dec;138(6):764-9. doi: 10.1016/0002-9610(79)90293-9.
Distal embolization of fragmented laminated thrombus and atheroma producing peripheral ischemia or gangrene is an underemphasized complication of arterial reconstruction. A set of techniques has been developed to minimize this important complication. To assess their effectiveness, the incidence of distal embolism in patients undergoing resection of abdominal aortic aneurysm with and without the use of these techniques was studied. In the 434 patients who underwent elective resection of abdominal aneurysm, measures to prevent distal embolism were used in all cases. The incidence of distal embolism was only 0.23 per cent (1 of 434), in contrast to reported incidences of up to 11 per cent. In the 21 patients who underwent emergency resection of ruptured aneurysm, these techniques were not used due to the need for early proximal control for resuscitation; distal embolism of atheromatous material occurred in 2 cases, an incidence of 9 per cent. The application of these techniques to other peripheral vascular procedures has resulted in similar low rates of postoperative distal ischemia.
碎裂的分层血栓和动脉粥样硬化斑块的远端栓塞导致周围缺血或坏疽是动脉重建中一个未得到充分重视的并发症。已经开发出一套技术来尽量减少这一重要并发症。为评估其有效性，研究了在使用和不使用这些技术的情况下，接受腹主动脉瘤切除术患者的远端栓塞发生率。在434例行择期腹主动脉瘤切除术的患者中，所有病例均采取了预防远端栓塞的措施。远端栓塞发生率仅为0.23%（434例中的1例），而报告的发生率高达11%。在21例行破裂动脉瘤急诊切除术的患者中，由于需要早期近端控制以进行复苏，未使用这些技术；2例发生动脉粥样硬化物质的远端栓塞，发生率为9%。将这些技术应用于其他周围血管手术也导致术后远端缺血发生率同样较低。
