Crutchfield E H, Katras T, Stanton P E
Department of Surgery, East Tennessee State University, Johnson City 37614, USA.
Am Surg. 1998 Nov;64(11):1079-81.
We present a case report of a previously healthy 33-year-old white male with a long history of intravenous drug use, who presented to our institution with bilateral ischemia of his lower extremities, secondary to thromboemboli. Initial surgical intervention included bilateral femoral thrombectomies, right distal popliteal thrombectomy, and left lower extremity fasciotomy for compartment syndrome. Diagnostic evaluation using transthoracic two-dimensional echocardiography failed to demonstrate a cardiac or thoracic source for these thrombi. Transesophageal echocardiography did demonstrate a mural thrombus of the proximal descending thoracic aorta, approximately 2 cm distal to the origin of the left subclavian artery, at the position of the ligamentum arteriosum. Confirmation was attained using CT and aortography. The patient was successfully treated with resection and placement of an interposition graft.
我们报告一例病例，患者为一名33岁既往健康的白人男性，有长期静脉吸毒史，因血栓栓塞继发双下肢缺血前来我院就诊。初始手术干预包括双侧股动脉血栓切除术、右腘动脉远端血栓切除术以及因骨筋膜室综合征行左下肢筋膜切开术。经胸二维超声心动图诊断评估未能发现这些血栓的心脏或胸部来源。经食管超声心动图确实显示在左锁骨下动脉起源远端约2 cm处、动脉韧带位置的降主动脉近端有一壁血栓。通过CT和主动脉造影得以证实。患者接受切除并置入间置移植物后成功治愈。
