Segmental renal artery and popliteal artery embolism in an adult patient with rheumatic heart disease and atrial fibrillation: A case report

Parajuli, Pawan; Luitel, Bhoj Raj; Chapagain, Suman; Pradhan, Manish; Gnyawali, Diwas; Sigdel, Prem Raj; Pandit, Durga; Guragain, Bipin; Chudal, Sampanna; Verma, Rupesh; Poudyal, S; Chalise, Pawan Raj; Sharma, Uttam

doi:10.1016/j.ijscr.2020.11.097

Cited by 1 publication

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“…Гострий тромбоз артерій підколінно-гомілкового (infrapopliteal) сегменту є важкою патологією, оскільки відсоток ампутацій в даній групі пацієнтів значно вищий, ніж при тромбозах інших артеріальних сегментів нижніх кінцівок [1,2]. Основними при-чинами виникнення гострого тромбозу підколінногомілкового сегменту є емболія підколінної артерії [3], облітеруючий тромбангіїт (хвороба Бюргера) [4,5,6] та аневризма підколінної артерії [7,8]. Вибір методу лікування та його результат безпосередньо залежить від вияснення етіології виникнення тромбозу.…”

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Surgical Treatment of Acute Thrombosis Arteries of Infrapopliteal Segment

Hupalo¹,

Nabolotnyi

Kulikovskyi

et al. 2021

Clin. and prev. med.

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Aim of the study. Aim of the study was to analyze the outcomes of surgical treatment of acute thrombosis of the popliteal-tibial segment arteries with various etiological factors of its occurrence. The analysis of the surgical treatment of 40 patients with acute thrombosis of the popliteal-tibial segment arteries was carried out for the period from 2014 to 2020. Depending on the pathogenesis of acute thrombosis of the popliteal-tibial segment arteries, the patients were divided into three groups: Group 1 – 17 (42.5%) patients with acute arterial thrombosis of the popliteal-tibial segment caused by embolism or thrombosis in the background of stenotic-occlusive diseases of the lower extremitiesvessels; Group 2 – 15 (37.5%) patients with acute arterial thrombosis of the popliteal-tibial segment in the background of thromboangiitisobliterans of the lower extremities (Buerger's disease); Group 3 – 8 (20%) patients with acute arterial thrombosis of the popliteal-tibial segment in the background of popliteal artery aneurysm. During the follow-up period of 2 months, the incidence of rethrombosis and amputation of the lower limb in the patients of Group A was 5.9% and 5.9%, respectively. In Group B, the incidence of rethrombosis and amputation of the lower limb was 73.3% and 40.0%, respectively. In group C, the incidence of rethrombosis and amputation of the lower limb was 12.5% and 12.5%, respectively. Conclusions. In patients with acute arterial thrombosis of the popliteal-tibial segment in the background of embolism or stenotic-occlusive diseases, combined endovascular or hybrid surgical interventions showed better results compared to open thrombectomy, in which rethrombosis was diagnosed in 14.3% of cases. In patients with thromboangiitis obliterans of the lower extremities, regional catheter-directed thrombolysis showed better (p=0,04) results compared to open thrombectomy and endovascular interventions, in which rethrombosis was diagnosed in 90% and 100% of cases, respectively. In patients with popliteal artery aneurysm, open surgical interventions or regional catheter-directed thrombolysis showed better results compared to endovascular interventions, in which rethrombosis was diagnosed in 50% of cases.

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