Abstract:
Acute limb ischemia (ALI) related to total knee arthroplasty (TKA) is rare. Most occlusions are caused by thrombus formation in the popliteal artery (PA). Currently such cases are revascularized using less invasive approaches such as endovascular therapy or Fogarty thrombectomy. We report a case of ALI in a 65-year-old woman with complete rupture of the PA due to a TKA procedure. She had resting pain and motor paralysis in her right lower extremity after TKA. Contrast-enhanced computed tomography showed occlusion of the right femoropopliteal artery. Subsequently, she was referred to our hospital with a diagnosis of ALI. Initially, a less invasive revascularization procedure was unsuccessfully attempted. Therefore, we performed an emergency distal bypass and succeeded in revascularization. Intraoperative examination revealed a complete rupture of the PA. Postoperatively, the patient exhibited no signs of myonephropathic metabolic syndrome. Although there was significant motor impairment, the affected limbs were successfully salvaged. ALI with complete rupture of the PA associated with TKA has not been reported previously. In cases of iatrogenic ALI after TKA, it would be essential to consider diagnostic and revascularization methods that account for the possibility of severe injury to the PA.
UNASSIGNED: Acute limb ischemia after total knee arthroplasty is a rare and life- and limb-threatening condition. The underlying pathological mechanism is often thrombus occlusion due to mechanical stimuli of the popliteal artery (PA). There are no established treatments for this condition, and less invasive approaches such as endovascular procedures and Fogarty thrombectomy are often used. However, in cases involving severe damage to the PA, bypass surgery may be necessary, and revascularization procedures should be considered accordingly.
摘要:
与全膝关节置换术(TKA)有关的急性肢体缺血(ALI)罕见。大多数闭塞是由the动脉(PA)中的血栓形成引起的。目前,此类病例使用侵入性较小的方法进行血运重建,例如血管内治疗或Fogarty血栓切除术。我们报告了一例由于TKA手术导致PA完全破裂的65岁女性的ALI病例。TKA后,她的右下肢有静息疼痛和运动麻痹。对比增强计算机断层扫描显示右股pop动脉闭塞。随后,她被转诊到我们医院诊断为ALI。最初,侵入性较小的血运重建手术未能成功.因此,我们进行了紧急远端旁路手术,并成功进行了血运重建.术中检查显示PA完全破裂。术后,患者未表现出肌肾病代谢综合征的征象.尽管有明显的运动障碍,患肢被成功抢救。先前尚未报道与TKA相关的PA完全破裂的ALI。在TKA后医源性ALI的情况下,考虑考虑PA严重损伤可能性的诊断和血运重建方法至关重要.
■全膝关节置换术后急性肢体缺血是一种罕见且危及生命和肢体的疾病。潜在的病理机制通常是由于the动脉(PA)的机械刺激引起的血栓闭塞。这种情况没有确定的治疗方法,通常使用血管内手术和Fogarty血栓切除术等侵入性较小的方法。然而,在涉及PA严重损坏的情况下,搭桥手术可能是必要的,应考虑相应的血运重建程序。