Acute Obstructive Disease of the Extremities

  • H. Denck

Abstract

Acute arterial obstruction may be caused by embolism of dislodged thrombotic material or by acute arterial thrombosis of an artery with a diseased or injured wall. Other causes of acute arterial obstructions are trauma, posttraumatic changes of the artery, dissecting aneurysms, subintimal hematoma, spastic diseases of the arteries, and several rare conditions. The main source of arterial embolism is the heart, from which 75%–94% of all peripheral emboli originate [21, 23, 26, 28]. Over the last few decades, the main cause of embolism from the heart — rheumatic valve disease and atrial thrombosis with atrial fibrillation — has been replaced by embolism of parietal mural thrombi following myocardial infarction [21]. Rheumatic heart disease has dropped to second place among the causes of embolism.

Keywords

Catheter Ischemia Heparin Perforation Lidocaine 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Baue AE, McClerikn WW (1965) A study of shock, acidosis and the declamping phenomenon. Ann Surg 161:40CrossRefGoogle Scholar
  2. 2.
    Bywaters EGL (1944) Ischemic muscle necrosis: crushing injury, traumatic edema, the crush syndrome, traumatic anuria, compression syndrome a type of injury seen in air raid casualities following burial beneath debris. JAMA 124:1103CrossRefGoogle Scholar
  3. 3.
    Chidi CC, Depalma RG (1983) Atherogenic potential of the embolectomy catheter. Surgery 83/5:549–557Google Scholar
  4. 4.
    Denk W (1934) Zur Behandlung der arteriellen Embolie. MMW 81:437–439Google Scholar
  5. 5.
    Egan TJ, Daly M (1981) Acute upper limb ischemia in the thoracic outlet syndrome: its correction by axillo-axillary bypass grafting. Angiology 32/9:639–641PubMedCrossRefGoogle Scholar
  6. 6.
    Fadden Mc PM, Ochsner JL, Mills N (1983) Management of thrombotic complications of invasive arterial monitoring of the upper extremity. J Cardio-vasc Surg 24:35–39Google Scholar
  7. 7.
    Field T, Littooy FN, Baker WH (1982) Immediate and long-term outcome of acute arterial occlusion of the extremities. The effect of added vascular reconstruction. Arch Surg 117/9:1156–1160PubMedCrossRefGoogle Scholar
  8. 8.
    Fogarty TJ, Cranley J J, Krause ES, Strasser S, Hafner CT (1963) A method for extraction of arterial emboli and thrombi. Surg Gynecol Obstet 116:241–244PubMedGoogle Scholar
  9. 9.
    Fogarty TJ (1967) Catheter technique for arterial embolectomy. J Cardiovasc Surg 8: 22–28Google Scholar
  10. 10.
    Fogarty TJ, Daily PO, Shumway NE, Krippaehne WW (1971) Experience with ballon catheter technic for arterial embolectomy. Am J Surg 122:231PubMedCrossRefGoogle Scholar
  11. 11.
    Gautier R, Gordeeff A, Fourquet JQ, Gelas P, Jacquot C, Fauvage B (1982) Dissection auguè de l’aorte de stade III avec ischémie abdominale et jambière. Traitement par pontage aortoiliaque et revascularisations digestives. Chirurgie 108/3: 228–233PubMedGoogle Scholar
  12. 12.
    Goldberg EM, Goldberg MC, Chowdhury LN, Gould SA (1983) The effects of embolectomy-thrombectomy-catheters and vascular architecture. J Cardiovasc Surg 24:74–80Google Scholar
  13. 13.
    Hagmüller GW, Denck H, Russe F, Veit F (1982) Die aortoarterielle Embolie als Komplikation atheromatöser und aneurysmatischer Veränderungen der distalen Bauchaorta. Angio Arch 3:75–78Google Scholar
  14. 14.
    Haimovici H (1960) Arterial embolism with acute massive ischemic myopathy and myoglobinuria. Surgery 47:739PubMedGoogle Scholar
  15. 15.
    Haimovici H (1979) Metabolic complications of acute arterial occlusions. J Cardiovasc Surg 20: 349–358Google Scholar
  16. 16.
    Haimovici H (1979) Muscular, renal, and metabolic complications of acute arterial occlusions: Myonephropathic-metabolic syndrome. Surgery 85/ 4:461–468PubMedGoogle Scholar
  17. 17.
    Hess H, Mietaschk A (1983) Fibrinolytische Therapie bei den arteriellen Verschlußkrankheiten. Indication und Ergebnisse. Hämostaseologie 23: 2Google Scholar
  18. 18.
    Hirst AE Jr, Johns VJ, Kime SW Jr (1958) Dissecting aneurysm of aorta. Review of 505 cases. Medicine 37:217–279PubMedCrossRefGoogle Scholar
  19. 19.
    Kealy WF (1978) Atheroembolism. J Clin Pathol 31/10: 984–989PubMedCrossRefGoogle Scholar
  20. 20.
    Kniemeyer HW, Sandmann W, Winter J, Kaschner A, Nüllen H, Noack E (1983) Spastische Gefäßreaktion nach Dihydroergotamin-Komplikationen der postoperativen Thromboembolieprophylaxe. Aktuelle Chir 6/18:199–248Google Scholar
  21. 21.
    Lusby RJ, Wylie EJ (1983) Acute lowers limb ischaemia: pathogenesis and management. World J Surg 7:340–346PubMedCrossRefGoogle Scholar
  22. 22.
    Pratt GH (1954) Cardiovascular Surgery. Kimpton, LondonGoogle Scholar
  23. 23.
    Senn A (1963) Die chirurgische Behandlung der akuten und chronischen arteriellen Verschlüsse. Huber, BerlinGoogle Scholar
  24. 24.
    Shah PM, Clauss RH (1983) Dissecting hematoma presents as acute lower limb ischemia. Diagnostic patient profile and management. J Cardiovasc Surg 24: 649–653Google Scholar
  25. 25.
    Sheiner Nm, Zeltzer J, Macintosh E (1982) Arterial embolectomy in the modern era. Can J Surg 25/ 4:373–375PubMedGoogle Scholar
  26. 26.
    Vollmar J (1983) Rekonstruktive Chirurgie der Arterien. Thieme, Stuttgart New YorkGoogle Scholar
  27. 27.
    Williams GM, Harrington D, Burdick J, White RI (1981) Mural thrombus of the aorta: an important, frequently neglected cause of large peripheral emboli. Ann Surg 194/6:737–744PubMedCrossRefGoogle Scholar
  28. 28.
    Wuppermann TH. Klinik, Differentialdiagnose und Therapie des akuten Beinarterienverschlusses. Phlebol. Proktol 12:16–20Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • H. Denck

There are no affiliations available

Personalised recommendations