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猫体内主动脉异物导致缺血性神经肌肉病及侧支循环形成

Aortic foreign body resulting in ischemic neuromyopathy and development of collateral circulation in a cat.

作者信息

Whigham H M, Ellison G W, Graham J

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville 32610-0125, USA.

出版信息

J Am Vet Med Assoc. 1998 Sep 15;213(6):829-32, 819.

PMID:9743722
Abstract

A cat evaluated for paraplegia had firm pelvic limb musculature and did not have femoral pulses. External wounds were not evident, but abdominal radiography revealed a round metallic foreign body on the midline ventral to the sixth lumbar vertebra. Angiography indicated stenosis or thrombosis of the aorta in association with the foreign body; collateral circulation arose from the fifth lumbar artery. Arteriotomy was performed to extract the foreign body and associated thrombi. Six weeks after surgery, angiography revealed blood flow in the abdominal portion of the aorta, but no evidence of obstruction or additional collateral vessels. The cat regained function of the pelvic limbs within 1 year after surgery. Ischemic neuromyopathy and paraplegia in cats is commonly associated with aortic thromboembolism. A thrombus is necessary to cause typical clinical signs, and vasoactive substances released by platelets in the thrombus are believed to cause ischemic neuromyopathy. Progression of the collateral circulation may allow for clinical improvement without surgical intervention.

摘要

一只因截瘫接受评估的猫,其盆腔肢体肌肉坚实且股动脉搏动未触及。体表未见伤口,但腹部X光检查显示在第六腰椎腹侧中线处有一个圆形金属异物。血管造影显示主动脉与异物相关处存在狭窄或血栓形成;侧支循环由第五腰动脉发出。进行动脉切开术以取出异物及相关血栓。术后六周,血管造影显示主动脉腹部段有血流,但无梗阻或额外侧支血管的迹象。这只猫在术后1年内恢复了盆腔肢体功能。猫的缺血性神经肌肉病和截瘫通常与主动脉血栓栓塞有关。血栓是导致典型临床症状所必需的,血栓中血小板释放的血管活性物质被认为会引起缺血性神经肌肉病。侧支循环的进展可能使临床症状在无需手术干预的情况下得到改善。

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