J.Jpn. Surg. Soc.. 82(9): 1010-1014, 1981
Report on the annual meeting
THE IMPORTANT FACTORS IN THE TREATMENT FOR TIME-ELAPSING CASES OF ACUTE ARTERIAL OCCLUSION
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Department of Surgery, Osaka Medical College Susumu Masuoka, Tadao Shimomura, Tsuguhiko Ando, Kenzo Goto, Satoshi Kawai, Kunio Okajima |
I) Ischemic limbs were classified into three groups (viability (-), (±), (+)) onthe basis of clinical assessment of their viability. Viability (+) was defined as no muscular rigidity, no tenderness to the muscles and no sensory disturbance. On the contrary, viability (-) was defined as marked rigidity of the muscles with severe tenderness or necrosis of muscles, sensory disturbance and motor loss. As a result of this survey, it is concluded that arterial reconstruction should be performed in viability (+) or (±) group, whereas primary amputation should be taken into consideration in the viability (-) group.
2) Because of the stable adherence of emboli or thrombi to the arterial endothelium in the time-elapsing group, embolectomy or thrombectomy under direct vision will improve operative results, combined with use of a Fogarty balloon catheter.
3) The evaluation of changes in serum enzyme activities such as creatine phosphokinase (CPK) might contribute to the determination of prognosis in the time-elapsing cases of acute arterial occlusion. However, one should pay attention to the facts that CPK had a tendency to decrease with the lapse of time, which was proved in our experiment concerning acute arterial occlusion.
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