The Differentiation Of Clinical Factors Between Acute Arterial Embolism And Acute Arterial Thrombosis Of The Lower Extremities

Objective To investigate the differentiation of clinical factors between acute arterial embolism and acute arterial thrombosis in patients with acute lower extremity ischemia. To make a variety of clinical factors for accurate assessments, correctly identify the cause of acute lower limb ischemia, in order to make the correct diagnosis and effective to guide further treatment, to achieve the desired therapeutic effect.Methods A total of 115 patients with acute ischemia of lower extremity in the department of vascular surgery in Jining Medical College Affiliated Hospital during 2006 January 1st to 2016 January 1st. Depending on the DSA findings, the patients were divided into AE group(n=83) and AT group(n=32).The onset of the disease, the obstructed sites,the severity of ischemia,the clinical manifestations and the condition of the diseased limb were retrospectively analyzed and compared between the two groups. Statistical analysis and chi-square test to study the correlation between AE and AT.Results The AE occurred usually on the iliac-femoral artery(χ2=6.725,P<0.05), while the vascular-disorders caused by acute AT often involved many sites(P=0.007).clinical manifestations such as dyskinesia(χ2=13.121,P<0.05)and impaired sensation(χ2=7.425,P<0.05)were more severe occurred on the patient with AE, and showed normal peripheral pulse on the healthy limb(χ2=23.903,P<0.05). Intermittent claudication were more often accomplished with the patients of AT(χ2=11.777,P<0.05). The severity of ischemia in patients with AE tended to become immediately threatened Ⅱb grade(χ2=11.985,P<0.05),while IIa grade(χ2=13.541,P<0.05) was more often observed in patients with AT. Hypertension( χ2=10.97, P<0.05)、 diabetes mellitus( χ2=6.074, P<0.05), and smoking habit(χ2=7.929,P<0.05)were more commonly found in patients with acute arterial thrombosis than in patients with acute arterial embolism.Atrial fibrillation(χ2=22.063,P<0.05)had a strong predilection for patients with acute arterial embolism. Previous arterial embolism history( χ2=6.151, P<0.05) was only seen in patients with acute arterial embolism.Conclusion It can identify effectively clinical factors of acute arterial embolism and acute arterial thrombosis. The history of intermittent claudication and previous arterial embolism,the obstructed sites,clinical manifestations(impaired sensation, dyskinesia and peripheral pulse condition of the healthy limb),the severity of ischemia, and the high-risk factors of the peripheral vascular disease( mellitus, hypertension, smoking habit and atrial fibrillation).