O'Donnell T F
Division of Vascular Surgery, Tufts University School of Medicine, Boston, Mass.
Can J Surg. 1993 Aug;36(4):349-53.
Acute ischemia of the lower extremity is associated with reduced blood flow to muscle, nerve, subcutaneous tissue and skin. This condition may be caused by thrombosis on an atherosclerotic plaque or embolus or by the occlusion of a previously placed arterial bypass graft. The difficulties in differentiating embolic arterial occlusion from acute thrombotic arterial occlusion are discussed. Although balloon catheter thrombectomy has been the traditional approach to treatment of patients with acute ischemia, this method has several disadvantages: it may not remove all of the thrombus, the thrombus may be inaccessible, it may damage vessels and atherosclerotic plaque and it does not identify or correct the underlying cause of the thrombosis. The advantages of catheter-directed thrombolysis are discussed, including its use as a diagnostic tool. Detailed techniques are presented along with data from extensive studies.
下肢急性缺血与流向肌肉、神经、皮下组织和皮肤的血流量减少有关。这种情况可能由动脉粥样硬化斑块或栓子上的血栓形成引起，也可能由先前放置的动脉旁路移植物闭塞所致。本文讨论了鉴别栓塞性动脉闭塞与急性血栓性动脉闭塞的难点。尽管球囊导管取栓术一直是治疗急性缺血患者的传统方法，但该方法存在几个缺点：它可能无法清除所有血栓，血栓可能难以触及，可能会损伤血管和动脉粥样硬化斑块，并且无法识别或纠正血栓形成的根本原因。本文讨论了导管定向溶栓的优点，包括其作为诊断工具的用途。文中介绍了详细技术以及来自广泛研究的数据。
