55 Ps:

(Pain):80%,

(Pallor) :
,
(Paresthesia,
Paralysis) :
(Pulselessness) :

(embolus)1977
Fogarty338
94%77%

60%
20%

xxx (2011)
xxx

xxx

urokinase3

235

 JOURNAL OF KAOHSIUNG MEDICAL ASSOCIATION 2013. vol.21, No.3

15
30

3060

612
1220
2448

embolismthrombosis

48

68

compartment syndrome

20-30mmHg
(Fasciotomy)

reperfusion injury
animal model

heparin, mannitol, prostaglandin

: Duplex sonography

236

duplex sonography

Chest X ray,
EKG, cardiac echo

(1):
Fogarty

1/3

(2)

(3):
,,
,
: (1)
(2)

LDH.SGOT.CPK
(3)

(fogarty
catheter)
thrombectcmy

: warfarin

3
7

237

 JOURNAL OF KAOHSIUNG MEDICAL ASSOCIATION 2013. vol.21, No.3

(intra-arterial
thrombolysis)

--

open embolectomy via common femoral

artery or popliteal arteryintra-arterial
thrombolysisfogarty
catheterembolectomy or thrombectomy
common
femoral or popliteal artery 250000 IU
urokinasembolectomyvascular
infusion cathetersuperficial femoral
artery or popliteal arteryinfusion
catheterurokinase3-5(
refilling time
)

Reference:
(1) Schumann R, Rieger J, Ludwig M. Med
Klin (Munich)et al:.Acute peripheral
arterial occlusive disease. 2007 Jun 15;
102(6):457-71; quiz 472-3
(2) Ansel GM, Botti CF Jr, Silver MJ. Catheter
Cardiovasc Interv. Treatment of acute limb
ischemia with a percutaneous mechanical
thrombectomy-based endovascular
approach: 5-year limb salvage and survival
results from a single center series. 2008 Sep
1; 72(3):325-30.
(3) Treatment of acute occlusion of peripheral
arteries. Costantini V, Lenti M. Thromb
Res. 2002 Jun 1; 106(6):V285-94.
(4) Acute limb ischemia. Semin Vasc Surg.
1999 Jun ;12(2):148-53.
(5) Katzen BT. Clinical diagnosis and
prognosis of acute limb ischemia. Rev
Cardiovasc Med 2002; 3 Suppl 2:S2.
(6) Alonso-Coello P, Bellmunt S, McGorrian
C, et al. Antithrombotic therapy in
peripheral artery disease: Antithrombotic
Therapy and Prevention of Thrombosis, 9th
ed: American College of Chest Physicians
Evidence-Based Clinical Practice
Guidelines. Chest 2012; 141:e669S.
(7) Huettl EA, Soulen MC. Thrombolysis
of lower extremity embolic occlusions: a
study of the results of the STAR Registry.
Radiology 1995; 197:141.

Heparinwarfarin
Heparin

238