Surowiec S M, Isiklar H, Sreeram S, Weiss V J, Lumsden A B
Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Am J Surg. 1998 Aug;176(2):193-7. doi: 10.1016/s0002-9610(98)00129-9.
Acute aortic occlusion most commonly results from aortic saddle embolus or thrombosis of an atherosclerotic abdominal aorta. The purpose of this study was to review the experience at a university hospital to better define the diagnosis and management of this uncommon process.
A retrospective chart review was performed from patients admitted to Emory University Hospital with acute occlusion of the abdominal aorta from 1985 through 1997.
Thirty-three patients were identified. In group EMB (n = 16), occlusion was due to saddle embolus. In group IST (n = 17), occlusion was attributed to in situ thrombosis of a severely diseased aorta. Operative procedures performed included transfemoral embolectomy (15), aorto-bifemoral bypass (9), axillobifemoral bypass (5), fasciotomy (3), and thrombolysis (1). The in-hospital mortality rate was 21% (31% EMB, 12% IST), and morbidity was significant and included mesenteric ischemia (6%), bleeding complications (9%), subsequent amputation (12%), renal failure (15%), recurrent embolization or thrombosis (21%), and cardiac complications (42%).
Acute aortic occlusion has tremendous morbidity and mortality even with optimal surgical care.
急性主动脉闭塞最常见的原因是主动脉骑跨栓子或腹主动脉粥样硬化血栓形成。本研究的目的是回顾一所大学医院的经验，以更好地明确这一罕见病症的诊断和治疗方法。
对1985年至1997年因腹主动脉急性闭塞入住埃默里大学医院的患者进行回顾性病历审查。
共确定33例患者。在EMB组（n = 16）中，闭塞是由骑跨栓子引起的。在IST组（n = 17）中，闭塞归因于严重病变主动脉的原位血栓形成。实施的手术包括经股动脉取栓术（15例）、主动脉-双股动脉搭桥术（9例）、腋-双股动脉搭桥术（5例）、筋膜切开术（3例）和溶栓术（1例）。住院死亡率为21%（EMB组为31%，IST组为12%），发病率较高，包括肠系膜缺血（6%）、出血并发症（9%）、后续截肢（12%）、肾衰竭（15%）、复发性栓塞或血栓形成（21%）以及心脏并发症（42%）。
即使采取最佳的手术治疗，急性主动脉闭塞仍具有极高的发病率和死亡率。
