Operations in acute arterial obstruction
Cardiovascular Diseases / / May 07, 2016
angioplasty and heart
(method of operation)
main method of surgical treatment is embolism embolectomy, t. E. Removal of emboli from the vessel lumen.Embolectomy depending on how they perform divided into direct and indirect.For such operations are directly related in which to remove the embolus expose and reveal the directly affected area of the artery.Indirect include operations in which the removal of emboli from hard arteries produced through other, more affordable.Most often have to deal with embolism aortic bifurcation, iliac, femoral, popliteal, humeral, subclavian arteries.
Direct embolectomy from the femoral artery
The patient - on the back.
Anesthesia - local infiltration anesthesia.
course of operations. incision 10-12 cm expose the femoral artery in skarpovskom triangle.After the end of the overlap of the central artery vascular clamp cover all the off collaterals with rubber catheters (derzhalok).In peripheral artery division (below embolus) also impose clip.The next
following schematic presents various methods for removing emboli.
Removing embolus blood stream.
embolus removal forceps
embolus removal by "squeezing»
embolus removal vacuum suction
recently for embolectomy with the continuation of thrombosis of the main arteries began to apply a special balloonthe catheter (Fogarty catheter) - a flexible elastic tube about 2 mm in diameter.At one end it has a pavilion for syringe attachment, on the other - a rubber balloon.In the lumen of the catheter introduced into a metal mandrel, giving it the necessary flexibility during the thrombotic mass through.After the catheter through the thrombotic mass beyond the thrombosed area to spray the liquid injected from a syringe.After obturation of the lumen of the artery reverse traction is recovered, removing the thrombotic mass.After removal of the embolus check artery patency test by first bloodletting of the central end of the artery, and then from the peripheral.Convinced of the artery patency, arteriotomicheskoe opening sutured continuous single-row obvivnym atraumatic suture needle.If the seams between the bleed blood, the nurse should prepare swab moistened with warm isotonic sodium chloride solution, which is applied to the joints line.If bleeding after 3-5 minutes did not stop, impose additional seams.Surgical wound is sutured in layers tightly, leaving a thin rubber glove drainage in the lower corner of her.