Stent thrombectomy for acute upper limb ischemia associated with thrombosis or thromboembolism: a case series

Q4 Medicine

Patologiya krovoobrashcheniya i kardiokhirurgiya Pub Date : 2023-06-30 DOI:10.21688/1681-3472-2023-2-87-93

I. S. Sem’in, A. N. Ivanenko, G. A. Sobolev, A. Kiselev, A. Kazantsev, A. Korotkikh, I. V. Chernikova, V. Unguryan

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Abstract

Objective: To evaluate the effectiveness of endovascular stent thrombectomy for acute upper limb ischemia caused by thrombosis or thromboembolism of the major arteries of the upper limb.Methods: We evaluated the effectiveness and safety of this technique in 18 patients with acute upper limb ischemia. The mean age was 72 (38‐93) years; 66.7% of the patients were women. Arterial hypertension was observed in 94.4% of the patients, and 38.9% of the patients had confirmed atrial fibrillation.Results: The primary success rate (complete revascularization according to angiography findings) was 83.3% (15 of 18 cases). We used this technique as a stand-alone procedure in 15 cases. Two patients received self-expanding stents, and 1 patient had selective thrombolytic therapy. In 3 cases we did not relieve symptoms of acute ischemia and perform any upper limb amputations during hospitalization, nor did we have any conversions to open surgery. Two patients died during hospitalization: one patient died of acute myocardial infarction, and another died of multiple organ dysfunction syndrome in the postoperative period.Conclusion: This endovascular thrombectomy technique in combination with other endovascular techniques is highly effective and has a number of benefits, such as low trauma, no need for general anesthesia, accurate intra- and postoperative patency control, timely detection of emboli with the possibility of their removal from arteries comparable in diameter to a stent delivery system (up to 1.8 mm). Received 15 February 2023. Revised 29 March 2023. Accepted 6 April 2023. Informed consent: The patient’s informed consent to use the records for medical purposes is obtained. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsLiterature review: A.V. Korotkikh, I.V. Chernikova, V.M. Unguryan, A.D. KiselevDrafting the article: A.N. Kazantsev, A.N. Ivanenko, G.A. SobolevCritical revision of the article: I.S. SeminSurgical treatment: A.N. Ivanenko, G.A. SobolevFinal approval of the version to be published: I.S. Semin, A.N. Ivanenko, G.A. Sobolev, A.D. Kiselev, A.N. Kazantsev, A.V. Korotkikh, I.V. Chernikova, V.M. Unguryan

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急性上肢缺血伴血栓形成或血栓栓塞的支架取栓术:病例系列

目的:评价血管内支架取栓术治疗上肢大动脉血栓形成或血栓栓塞引起的急性上肢缺血的疗效。方法:对18例急性上肢缺血患者的临床疗效和安全性进行评价。平均年龄为72岁(38‐93岁);66.7%的患者为女性。94.4%的患者出现动脉高血压，38.9%的患者确诊房颤。结果:18例患者中15例首次成功(血管造影显示完全血运重建)83.3%。我们在15例病例中使用该技术作为独立手术。2例患者接受自扩张支架，1例患者接受选择性溶栓治疗。在3例患者中，我们在住院期间没有缓解急性缺血症状，也没有进行任何上肢截肢手术，也没有进行任何转开腹手术。2例患者在住院期间死亡:1例患者死于急性心肌梗死，1例患者死于术后多器官功能障碍综合征。结论:这种血管内取栓技术与其他血管内技术联合使用是非常有效的，并且具有许多优点，如创伤小、不需要全身麻醉、准确的术中和术后通畅控制、及时发现栓塞并有可能将其从直径与支架输送系统相当的动脉中取出(最大1.8 mm)。2023年2月15日收到。2023年3月29日修订。2023年4月6日录用。知情同意:已取得患者知情同意将病历用于医疗目的。经费来源:本研究未获得赞助。利益冲突:作者声明无利益冲突。作者贡献文献综述:A.V. Korotkikh, I.V. Chernikova, V.M. Unguryan, A.D. kiselevv文章起草:A.N. Kazantsev, A.N. Ivanenko, G.A. sobolev文章关键修改:I.S. Semin手术治疗:A.N. Ivanenko, G.A. Sobolev, A.N. Kiselev, A.V. Korotkikh, I.V. Chernikova, V.M. Unguryan最终批准出版:I.S. Semin, A.N. Ivanenko, G.A. Sobolev, A.V. Kiselev, A.V. Chernikova

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