htmlOn the evening of September 20, Feng Bo's team of the Department of Vascular Surgery of Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine successfully treated a 185-year-old patient with right superficial femoral artery embolization .
The patient suddenly suffered severe pain, numbness and coldness on his right limb 2 hours before he was admitted to the hospital, and had difficulty walking. The patient with found that the patient with had cyanosis and coldness below the right knee, and the blood vessel pulsation disappeared. After electrocardiogram, color ultrasound and other related examinations, he was diagnosed as atrial fibrillation and acute arterial embolization of .
Patients with arterial embolism are in a state of limb ischemia for a long time, which will cause limb necrosis, muscle dissolution, and serious damage to renal function, resulting in the need to save their lives through amputation, and the situation is urgent. Considering the age of the patient, the platelet count is less than 50, the risk of thrombolysis bleeding is high, and there is a history of lameness. Considering the possibility of arterial stenosis , after discussion, the vascular surgery team formulated a surgical plan: undergoes arterial thrombectomy and thrombectomy under nerve block anesthesia, and further treatment after thrombectomy is performed using DSA and performs contrast and stenosis dilation to effectively avoid limb necrosis due to ischemia and ensure the surgical effect .
About 4 hours after the onset of the patient, the operation successfully removed the thrombus from the superficial femoral artery, about 4.6cm long, and the dorsal foot artery immediately resumed its pulsation. It takes only 12 minutes from incision of the arterial thrombectomy to completion of arterial suture, effectively shortening the limb ischemia time. The patient was then sent to the DSA room for angiography and stenosis dilation treatment. The contrast result was ideal and the operation was completed smoothly. After the operation, the patient's lower limb pain completely disappeared, the skin temperature returned, and he could get out of bed and move around the next day.
surgical procedure
case expansion
acute lower limb artery embolism refers to the obstruction of thrombus in the lower limb artery. The source of embolics mainly comes from the heart. Patients with arrhythmia , atrial fibrillation, heart pulmonary heart disease, valve insufficiency, and cardiac insufficiency form a thrombus in the heart and the thrombus falls off. As the blood flows to the surrounding arteries, the corresponding blood vessels will be blocked, resulting in symptoms of ischemia in the corresponding area.
Since the mid-1990s, some scholars have tried to combine the two technologies of interventional treatment of and surgical treatment, namely hybrid surgery , also known as compound surgery, which is used to treat long-segment occlusion of the lower limb artery or/and occlusion of the combined arterial bifurcation site. After years of exploration and accumulation of experience, this technology is now becoming more and more perfect, and has become an important method to treat long-term occlusion or/or occlusion of the lower limb artery and combined with occlusion of the bifurcation site.
Vascular acute diseases are often dangerous. If you have lower limb swelling, pain, numbness, cyanosis, blackness, etc., you should be highly vigilant about vascular diseases, especially arterial thromboembolism and deep venous thrombosis and deep venous thrombosis, and you should go to the vascular surgery department in time.
Expert recommendation
Feng Bo Deputy Director and Deputy Chief Physician of Vascular Surgery
11 graduated from Jiangxi Medical College major in clinical medicine. After graduation, he has been engaged in clinical and scientific research teaching of general surgical diseases. He went to the Department of Vascular Surgery of Changhai Hospital Affiliated to the Second Military Medical University to study and studied under Professor Jing Zaiping, the Chairman of the Department of Vascular Surgery of the entire army.
is good at lower limb varicose veins, deep vein thrombosis in the lower limbs, lower limb artery occlusion and peripheral vascular diseases minimally invasive interventional treatment, surgical treatment of liver and gallbladder diseases, hernia and gastrointestinal tumors. He served as an expert member of the Intraluminal Vascular Surgery Branch of the Chinese Medical Association, an expert member of the Grassroots Committee of the China Microcirculation Association, an expert member of the Hemodialysis Group of the International Vascular Alliance, and an expert member of the Jiangxi Branch of the Chinese Research Hospital Society of Vascular Medicine.
Wang Cong Teacher vascular surgery
Having been engaged in general surgery and vascular surgery for more than 20 years. In 2015, he went to the Department of Vascular Surgery of Renji Hospital of Shanghai Jiaotong University to study.He is good at minimally invasive interventional treatment of various arteriosclerosis occlusion, diabetic foot , establishment and maintenance of hemodialysis pathways, deep venous thrombosis in the lower limbs, tumor embolism, etc. He serves as an expert member of the Intraluminal Vascular Surgery Branch of the Chinese Medical Association, a member of the Jiangxi Vascular Surgery Branch of the Chinese Medical Association, a member of the Vascular Surgery Branch of the Jiangxi Association of Integrated Traditional Chinese and Western Medicine, and a member of the Youth Committee of the China Branch of the International Vascular Alliance.
Author: Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine Attendant Physician Wang Cong
Correspondent: Pan Xinqi Long Jianxin
Edited by: Huang Mengmei
Reviewed by: Chen Shirui
Published by: Xie Tao
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