Retrograde Trans-Amputation Embolectomy of Common, Superficial and Deep Femoral Arteries for Inflow Revascularisation During Above-Knee Amputation: A Case Report and Review of the Literature.

IF 0.7 4区医学 Q4 PERIPHERAL VASCULAR DISEASE Vascular and Endovascular Surgery Pub Date : 2023-10-01 Epub Date: 2023-05-04 DOI:10.1177/15385744231173193

Joel Jia Yi Soon, Darryl Lim

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Abstract

Background: Primary above-knee amputation (AKA) may at times be the only option for unsalvageable acute lower limb ischemia. However, occlusion of the femoral arteries may result in poor inflow and contribute to wound complications such as stump gangrene and sepsis. Previously attempted inflow revascularisation techniques include surgical bypass and percutaneous angioplasty and/or stenting.

Case presentation: We present a case of a 77-year-old lady with unsalvageable acute right lower limb ischemia secondary to cardioembolic occlusion of the common (CFA), superficial (SFA) and deep (PFA) femoral arteries. We performed a primary AKA with inflow revascularisation using a novel surgical technique involving endovascular retrograde embolectomy of the CFA, SFA and PFA via the SFA stump. The patient made an uneventful recovery without any wound complications. Detailed description of the procedure is followed by a discussion of the literature on inflow revascularisation in the treatment and prevention of stump ischemia.

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经股总动脉、股浅动脉和股深动脉逆行截肢栓塞治疗膝上截肢期间的流入性再出血：一例病例报告和文献复习。

背景：原发性膝上截肢（AKA）有时可能是无法治愈的急性下肢缺血的唯一选择。然而，股动脉闭塞可能导致流入不良，并导致伤口并发症，如残端坏疽和败血症。以前尝试的流入血运重建技术包括手术旁路和经皮血管成形术和/或支架植入术。病例介绍：我们报告了一例77岁的女性，因股总动脉（CFA）、股浅动脉（SFA）和股深动脉（PFA）的心脏栓塞闭塞而导致无法治愈的急性右下肢缺血。我们使用一种新的外科技术，通过SFA残端对CFA、SFA和PFA进行血管内逆行栓塞切除，进行了原发性AKA的流入血运重建。病人顺利康复，没有任何伤口并发症。在详细描述该程序后，讨论了有关流入血运重建治疗和预防残端缺血的文献。

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来源期刊

Vascular and Endovascular Surgery SURGERY-PERIPHERAL VASCULAR DISEASE

CiteScore

1.70

自引率

11.10%

发文量

132

审稿时长

4-8 weeks

期刊介绍： Vascular and Endovascular Surgery (VES) is a peer-reviewed journal that publishes information to guide vascular specialists in endovascular, surgical, and medical treatment of vascular disease. VES contains original scientific articles on vascular intervention, including new endovascular therapies for peripheral artery, aneurysm, carotid, and venous conditions. This journal is a member of the Committee on Publication Ethics (COPE).