The Application Of Embolectmy By Arteriotomy In Treating Acute Arterical Embolism Of Lower Limbs

Objectives:To study the clinical signficance of embolectomy by arteriotomy in treating acute arterial embolism of lower limbsMethods:1.We retropectively analysed 61 patients diagnosed acute arterialembolism of lower limb in The First Affiliated Hospital of Dalian Medical University who underwent embolectmy by arteriotomy treatment between January 2011 to January 2015.During hospitalization,we record their medical condition,postoperative complications.After they were discharged from hospital,they were followed-up for 1 year to record their clinical staging,ampution rate and death rate.2.Because acute lower limbs arterialembolism is related to the treatment of time and it was reported that time was an independent factor.We retrospectively analysed this patients of vascular surgery in our hospital who got the treatment time between January 2011 to January 2015.According to the hospitalization time 17 patients within 8 hours were the first group,15 patients between 8hours to 24 hours the second group,and 29 patients over 24 hours the the third group,and during the hospitalization,we record their medical condition,postoperative complications,their clinical staging,ampution rate and death rate with one year observation after hospital discharge.Results: 1.Sixty one patients(65 limbs)were operated and the results were successful.Seven patients with complications after operation take up 11.5%(including 5 bone compartment syndrome patients,1 renal failure patient,1electrolyte disturbances).Others have no complications after operation.Following-up for one year,there are 30 patients have cured in all arterial embolism in lower limbs(pain symptom disappeared,lower limb function recovered,the dorsal artery of the feet can be touched).And there are 22 patients have improvement(pain symptoms proposion disappeared,the dorsal artery of the feet cant be touched).Three patients died and 6 patients underwent amputation.Within 8 hours 2 of the 17 patients in treatment died(one due to renal arterial stenosis and the other was respiration failure).The rest that cured take up 88.2% and 3 patients with postoperative complications.Between 8 hours and 24 hours 2(13.3%)of the15 patients in treatment underwent amputation,8 patients(53.5%)crued,and5(3.3%)patients improved.Two patients have postoperative complications.Over 24 hours 7(24.1%)of the 29 patients in treatment cured,17(58.6%)patients improved,4(13.9%)paitints underwent amputation,1 patient(1.7%)died(due to renal funcation failure,acutecardial damage),and 2 patients have postopertive complications.The key to improve the limb salvage rate to cure acute arterical embolism in lower limbs was early discovery,early diagnosis and early treatment.So embolectomy by arteriotomy need to be performed within 8 hours.To recude the incidence of complcations,cut the rate and amputation rate.