[Femoro-popliteal emboli: treatment by manual thrombo-aspiration].
Acute arterial thrombo-embolic pathology constitutes a common pathology in the elderly population, principally in cases of cardiac arrhythmia. Out study allowed analysis of the results of percutaneous manual thrombo-aspiration as a primary procedure in a series of 25 patients (average age: 73.3 +/- 11.3 years) presenting with a picture of acute femoro-popliteal ischaemia, of supposed cardiac origin. Most of the patients had an arrhythmia with atrial fibrillation (68%), and 88% had grade II ischaemia. The site of proximal occlusion most frequently found was the popliteal axis (22 patients). Thrombo-aspiration was performed in all cases via the common femoral route homo-lateral with the ischaemia, by anterograde approach, after having obtained a diagnostic angiograph of the opposite side. The procedure, with an average duration of 39 minutes, allowed restoration of good quality flow in at least 2 axes subjacent to the occlusion in 23 patients (92%). Besides two failures, two complications (8%) were counted (one Scarpa haematoma and one early re-thrombosis). This good result was sustained long term, with 94% of patients reviewed on average 3 years after the procedure remaining asymptomatic. Manual thrombo-aspiration thus constitutes a technique of choice in the framework of the management of acute infra-inguinal emboli due to its angiographic and functional results on the one hand, and its low morbidity on the other, in a population particularly exposed to the risk of spontaneous and post-operative vascular complications.
Equine
O
O
Pôle cardiovasculaire interventionnel, hôpital privé d'Antony, 25, rue de la Providence, 92160 Antony.
Auguste
M
M
Aptecar
E
E
Dupouy
P
P
Hovasse
D
D
Lasry
J L
JL
Pernes
J M
JM
D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology; D011150:Popliteal Artery / Q000473:pathology*; D012189:Retrospective Studies; D013396:Suction; D013923:Thromboembolism / Q000628:therapy*; D016896:Treatment Outcome