Characteristics of lower limb malperfusion in aortic dissection and the reasons for misdiagnosis as lower extremity arterial thromboembolism

doi:10.3877/cma.j.issn.1674-0793.2015.01.005

Abstract

Abstract:

Objective

To investigate the characteristics of lower limb malperfusion (LLM) in type B aortic dissection (TBAD) and to analyze the reasons for misdiagnosis as acute lower extremity arterial thrombosis embolism.

Methods

A retrospective study was carried out of twenty-three patients with LLM in TBAD in our hospital from December 2011 to November 2014. The clinical characteristics were analyzed from history, chief complaint, diagnosis and treatment for the patients.

Results

All the 23 patients were diagnosed by CTA as LLM in TBAD. All patients were successfully treated with thoracic endovascular repair. Due to the sudden rupture of aortic dissection before anesthesia, 1 patient died of multiple organ failure on postoperative day 4. The remaining 22 patients were cured.

Conclusion

A correct understanding of the characteristics of LLM in TBAD, the careful and comprehensive analysis of clinical information, and the comprehensive grasp of vascular disease knowledge is the key to prevent misdiagnosis and mistreatment.

Key words: Aortic, Dissection, Lower extremity, Malperfusion, Thromboembolism

Mengtao Wu, Qingsheng Lu, Zhiqing Zhao, Junmin Bao, Zaiping Jing. Characteristics of lower limb malperfusion in aortic dissection and the reasons for misdiagnosis as lower extremity arterial thromboembolism[J]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(01): 18-21.

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References 20

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变量		患病数[例(%)]
全身症状		?
?	突发胸背撕裂痛	14(60.9)
?	突发胸闷、心慌	2(8.7)
?	突发头晕	2(8.7)
?	突发声嘶	2(8.7)
?	突发晕厥	3(13.0)
下肢发病部位		?
?	左	14(60.9)
?	右	6(26.1)
?	双	3(13.0)
下肢症状		?
?	间歇性跛行	2 (8.7)
?	股动脉搏动减弱或消失	21(91.3)
?	疼痛	18(78.3)
?	麻木	18(78.3)
?	肢体苍白	21(91.3)
?	运动障碍	5(21.7)

变量		患病数[例(%)]
全身症状		?
?	突发胸背撕裂痛	14(60.9)
?	突发胸闷、心慌	2(8.7)
?	突发头晕	2(8.7)
?	突发声嘶	2(8.7)
?	突发晕厥	3(13.0)
下肢发病部位		?
?	左	14(60.9)
?	右	6(26.1)
?	双	3(13.0)
下肢症状		?
?	间歇性跛行	2 (8.7)
?	股动脉搏动减弱或消失	21(91.3)
?	疼痛	18(78.3)
?	麻木	18(78.3)
?	肢体苍白	21(91.3)
?	运动障碍	5(21.7)

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