Analysis Of The Efficacy Of Two Surgical Treatments For Acute Arterial Embolism In Lower Extremity

Objective: To investigate the effectiveness and safety of patients with acute lower extremity arterial embolism who underwent femoral artery thrombectomy and catheter-directed thrombolysis(CDT).Methods: This is a retrospective analysis of patients with acute lower extremity arterial embolism admitted from January 2016 to June 2019 in our hospital(Second Hospital of Lanzhou University).According to the surgical method,patients were divided into the femoral artery thrombectomy group and the CDT group.By comparing the differences in surgical success rate,30-day mortality,amputation rate,and postoperative complications between the two groups,the effectiveness and safety of the two surgical methods were explored.Results: Of the 76 patients treated,44 patients underwent femoral artery thrombectomy,and 32 patients underwent CDT surgery.In the femoral artery thrombectomy group,two patients suffered from peripheral vascular disease.After the thrombectomy,the lower limb blood flow was poorly restored.One of them underwent femoral Endarterectomy,and the other with a contralateral saphenous vein bypass surgery.One patient in the CDT group underwent femoral artery endarterectomy for arteriosclerosis.In the CDT group,one patient had a pseudoaneurysm of the femoral artery,and three patients had bleeding at the puncture site.In the femoral artery thrombectomy group,2 cases had lymphatic fistula after operation and 5 cases had surgical site infection.Postoperative mortality(9.1%vs.6.3%),amputation rate(4.5% vs.3.1%),renal insufficiency / hyperkalemia rate(9.1% vs 9.4%)and incidence of compartment syndrome(4.5% vs.3.1%)in the thrombectomy group and CDT group.After analysis by statistical software,the mortality,amputation rate,the incidence of compartment syndrome and the incidenceof renal insufficiency / hyperkalemia were not statistically significant(p> 0.05).The infection rate in the femoral artery thrombectomy group was 11.4%,which was statistically significant(p <0.05).The bleeding rate in the CDT group was 9.4%,which was statistically significant(P <0.05).Conclusion: There was no statistically significant difference in amputation rate and mortality in patients with acute lower extremity arterial embolism after femoral artery thrombectomy and CDT surgery.But the femoral artery thrombectomy group had a higher infection rate than the CDT group in the surgical area.And the CDT group had a higher bleeding rate than the femoral artery thrombectomy group.Other complications were not statistically significant.