Lozano P, Gomez F T, Julia J, M-Rimbau E, Garcia F
Department of Angiology and Vascular Surgery, Hospital Son Dureta, Mallorca, Spain.
Ann Vasc Surg. 1998 Nov;12(6):609-11. doi: 10.1007/s100169900209.
A case of embolic recurrent episodes resulting in acute lower-limb ischemia from an unusual source is reported. This occurred in a patient on steroids for rheumatoid arthritis. Femoropopliteal thromboembolectomy successfully restored arterial flow. Diagnostic evaluation for identifying the source of embolism revealed a large, pedunculated and mobile thrombus arising from a nonaneurysmatic and nonatherosclerotic descending thoracic aorta. The thrombus was identified by transesophageal echocardiography and was successfully removed by aortic thromboendarterectomy. We emphasize the importance of transesophageal echocardiography as a reliable method for the diagnosis of thoracic aorta diseases and for identification of aortic thrombi. An aggressive surgical approach is recommended in the low-risk patient to prevent further embolic episodes.
报告了一例由不寻常来源导致急性下肢缺血的栓塞复发病例。该病例发生在一名因类风湿性关节炎而服用类固醇的患者身上。股腘动脉血栓切除术成功恢复了动脉血流。用于确定栓塞来源的诊断评估显示，一个大的、有蒂的活动血栓源自非动脉瘤性和非动脉粥样硬化性的降主动脉。经食管超声心动图识别出了该血栓，并通过主动脉血栓内膜切除术成功将其清除。我们强调经食管超声心动图作为诊断胸主动脉疾病和识别主动脉血栓的可靠方法的重要性。对于低风险患者，建议采取积极的手术方法以预防进一步的栓塞发作。
