Multiple embolism of arterial vessels of the systemic circulation: classification, clinical manifestations, and outcomes

Мельников, М. В.; Сотников, А В; Kozhevnikov, D. S.

doi:10.33529/angi02020319

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…Acute lower extremity arterial embolism (ALEAE) is a vascular surgical emergency caused by thrombus, atherosclerotic plaque, and other emboli falling off the heart or artery wall flowing with the blood and forming embolism at the artery of the lower extremity (1). There are many causes for the formation of AE, most of which are caused by slow blood flow and changes in blood viscosity of such patients, based on vascular stenosis caused by atherosclerotic plaques.…”

Section: Introductionmentioning

confidence: 99%

Clinical Study on Treatment of Acute Lower Extremity Arterial Embolism With Straub Thrombus Removal System

2022

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BackgroundAcute lower extremity arterial embolism (ALEAE) is a common and frequently occurring disease in clinics. Although thrombectomy with arteriotomy has been widely used and developed in clinics, there is a high probability of embolic recurrence after operation. The present study investigated the clinical efficacy of the Straub Rotarex system in the treatment of ALEAE, as it could remove exfoliative substances in acute and chronic cavities and expose diseased vessels.Materials and MethodsWe accessed our institutional database and retrospectively screened all patients with ALEAEs who received surgical treatment between April 2018 and April 2021. To observe the clinical efficacy, surgical indicators, incidence of postoperative complications, and recurrence rate of treatment with Straub Rotarex system and arteriotomy thrombectomy and analyze the risk factors for recurrence of embolism after treatment with Straub Rotarex system by multivariate Logistic regression model.ResultsFinally, 64 patients were included as the research object. The total effective rates of the observation group and the control group after operation were 100 and 93.75% respectively, and there was no significant difference between the two groups (P > 0.05). The intraoperative blood loss, postoperative off-bed time and hospital stay time in the observation group were significantly lower than those in the control group, and the operation time and hospitalization expenses were significantly higher than those in the control group (P < 0.05). The incidence of postoperative complications in the observation group was 3.13%, which was significantly lower than 18.76% of that in the control group (P < 0.05). The recurrence rates of the observation group and the control group were 15.63 and 18.76%, respectively. There was no significant difference in the recurrence rate between the two groups (P > 0.05). Atrial fibrillation was an independent risk factor for recurrence after the Straub thrombus removal system (P < 0.05).ConclusionStraub thrombus removal system is an effective method for the treatment of ALEAE. Although it prolongs the operation time and increases the operation cost as compared with thrombectomy, it effectively improves the operation safety, postoperative life quality, and postoperative recovery, thus, worthy of clinical promotion. Atrial fibrillation is an independent risk factor for recurrent embolism after the Straub thrombus removal system. Paying attention to the clinical diagnosis and treatment of patients with atrial fibrillation is of great significance for patients to choose a reasonable treatment, prevent a recurrence, and improve the prognosis.

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Section: Introductionmentioning

confidence: 99%

Clinical Study on Treatment of Acute Lower Extremity Arterial Embolism With Straub Thrombus Removal System

2022

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Pathogenesis of embologenic thrombosis of the left atrium in patients with atrial fibrillation

Сотников¹,

Мельников²,

Ivanova³

et al. 2021

Kardiol. serdechno-sosud. khir.

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Embolism to the main limb arteries in patients with atrial fibrillation

Мельников

Сотников

Kozhevnikov

et al. 2022

Regional blood circulation and microcirculation

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Introduction. Acute limb ischemia due to embolism in patients with atrial fibrillation remains poorly studied. Objective – to study the clinical significance and role of atrial fibrillation (AF) in the development of embolism to the bifurcation of the aorta and the main arteries of the limbs. Materials and methods. Treatment results of 1816 patients with acute ischemia of the extremities due to embolism treated at a specialized vascular surgical department for the past 30 years were analyzed. 1611 (88.7 %) of them had AF. The distribution into studied groups was according to the period time factor. Group 1 (n = 744) consisted of patients admitted in the period from 1991 to 2000; in group 2 (n = 568) – admitted in the period from 2001 to 2010, in group 3 (n = 299) – from 2011 to 2020. Methods included clinical examination, electrocardiography, Doppler-ultrasound, echocardiography. Results. The role of rheumatic heart disease as a cause of AF has decreased over the past decades by almost 10 times (from 19.5 % in group 1 to 2.0 % in group 3). Currently, the main background diseases for the development of AF are arterial hypertension and various forms of coronary artery disease. Embolism in patients with AF may develop in the arteries of all vascular areas of the systemic circulation, but in the practice of a vascular surgeon more often in the main arteries of minor caliber – the brachial (24.5 %) and popliteal (13.0 %). Multiple embolisms to various vascular areas were found in 2.8 % of patients. Urgent surgical revascularization of the limb by open embolectomy was performed in 1481 (91.9 %) patients that allowed 1348 (83.7 %) to be discharged with limb-sparing. Conclusion. In patients with acute limb ischemia of embologenic ethiology, comorbid AF has 88.7 % of them. Urgent embolectomy allows 83.7 % of patients to be discharged without limb amputation. Hospital mortality in the period 1991–2000 was 15.6 %, the last decade has been reduced to 7.4 %.

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Multiple embolism of arterial vessels of the systemic circulation: classification, clinical manifestations, and outcomes

Cited by 3 publications

References 4 publications

Clinical Study on Treatment of Acute Lower Extremity Arterial Embolism With Straub Thrombus Removal System

Clinical Study on Treatment of Acute Lower Extremity Arterial Embolism With Straub Thrombus Removal System

Pathogenesis of embologenic thrombosis of the left atrium in patients with atrial fibrillation

Embolism to the main limb arteries in patients with atrial fibrillation

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