Clinical feature and treatment for 130 cases of acute lower limb ischemia

2013 
Objective To investigate the clinical features and treatment of acute lower limb ischemia. Methods A retrospective analysis was carried out of patients who were admitted and treated for ALLI from January 2003 to December 2009. Results 82 cases of acute arterial embolism and 48 cases of acute thrombosis were studied. Clinical features: The overall incidence and co-incidence of CHD and AF was higher in the embolization group, and the patients in this group were treated earlier. In the acute thrombosis group: winter incidence was higher; men and smoking history were majority, older in average, and later for treatment. A systemic thrombolysis and anticoagulation therapy was taken in 12 cases and 9 patients undertook catheter thrombolysis. Fogarty catheter embolectomy procedures were performed in 81 cases, and 15 patients received immediate graft by-pass after the removal of thrombosis. An amputation was the first choice in 13 patients, and 8 patients underwent amputation of the second phase. A total of 27 patients underwent open decompression of compartment. Overall amputation rate was 16.15%; hospital mortality rate was 6.9%. Smoking, diabetes and onset time were independent risk factors for limb preservation. Conclusions ALLI should be treated as early as possible. Fogarty catheter embolectomy is effective for the acute arterial embolism. Preoperative assessment is important for acute arterial thrombosis and thrombolysis and/or graft by-pass should be used if necessary. Key words: Acute lower limb ischemia; Clinical feature; Treatment
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