Shah P M, Clauss R H
J Cardiovasc Surg (Torino). 1983 Nov-Dec;24(6):649-53.
Three unusual cases with dissecting hematoma of the thoracic aorta, presenting solely with unilateral ischemia of the right lower extremity, are described. The world literature is reviewed. We present the following patient profile to facilitate the diagnosis: (1) hypertensive middle aged black male, or (2) young white male with stigmata of Marfan's syndrome, both complaining of sudden unilateral ischemia of the right lower extremity. Common causes of acute arterial occlusion are absent. The diagnosis, once suspected, must be confirmed by immediate angiography before planning the treatment for the limb ischemia. We advocate femoro-femoral bypass to relieve acute limb-threatening when definitive management involves delay in scheduling or requires transfer to another institution.
本文描述了三例不寻常的胸主动脉夹层血肿病例，这些病例仅表现为右下肢单侧缺血。对世界文献进行了综述。我们呈现以下患者资料以助于诊断：（1）患有高血压的中年黑人男性，或（2）患有马凡综合征体征的年轻白人男性，二者均主诉右下肢突然单侧缺血。不存在急性动脉闭塞的常见病因。一旦怀疑有该诊断，在规划肢体缺血治疗方案之前，必须通过立即进行血管造影来确诊。当确定性治疗涉及安排延迟或需要转至另一机构时，我们主张进行股-股旁路手术以缓解急性肢体威胁。
