title: [Diagnosis and treatment of acute peroneal artery ischemia syndrome].
abstract: OBJECTIVE
  To put forward the concept of acute peroneal artery ischemia syndrome, and to study its typical clinical manifestations and imaging features so as to provide the basis of the evidence-based medicine for the diagnosis and treatment of acute peroneal artery ischemia.
  
  
  METHODS
  Between October 2009 and December 2012, 3 cases (2 males and 1 female, aged 57, 68, and 71 years) of acute peroneal artery ischemia syndrome were treated. All the patients displayed typical three symptoms of "peroneal artery blood supply zone pale/red + severe pain of the gastrocnemius muscle + acute drop foot". Medical examination revealed that they all had localized tenderness in the lateral and inferior part of the gastrocnemius muscle, with decreasing of skin temperature. The pulse of dorsalis pedis artery and the posterior tibial artery on affected limbs could be felt. Blood coagulation function and biochemical assay showed that D-dimer, fibrinogen degradation products, creatine kinase, or myoglobin markedly elevated. Magnetic resonance angiography revealed proximal peroneal artery stenosis. All patients were treated with intravenous thrombolysis, anticoagulation, vasodilation, and improving circulation therapy.
  
  
  RESULTS
  The symptoms of lower limb swelling, pain, and fatigue were improved obviously in all patients after treatment. Blood coagulation function and biochemical assay showed D-dimer, fibrinogen degradation products, creatine kinase, or myoglobin were gradually reduced. The patients were discharged at 9-13 days after treatments, without recurrence during the follow-up of 1 year.
  
  
  CONCLUSIONS
  Acute peroneal artery ischemia syndrome is a special type of acute lower limb ischemia, with the three symptoms of "peroneal artery blood-supply zone pale/red + severe pain of the gastrocnemius muscle + acute drop foot" as the main characteristics and should be treated by early active anticoagulant and recanalization therapy.
authors.affiliation: Department of Vascular and Endovascular Surgery, Peking University First Hospital, Beijing, P.R. China.
authors.forename: Kang
authors.initials: K
authors.lastname: She
authors.forename: Xiansheng
authors.initials: X
authors.lastname: Zhang
authors.forename: Jie
authors.initials: J
authors.lastname: Yin
authors.forename: Hongjie
authors.initials: H
authors.lastname: Guo
authors.forename: Gong
authors.initials: G
authors.lastname: Cheng
authors.forename: Weiliang
authors.initials: W
authors.lastname: Wang
mesh_terms: D000368:Aged; D005260:Female; D005528:Foot; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D016909:Tibial Arteries