Thrombosis of peripheral arteries
Contents:
Description:
Pathological intravital formation of a clot in a gleam of a peripheral artery.
Symptoms of Thrombosis of peripheral arteries:
The first symptoms of a disease are the cold snap of distal departments of an extremity and muscular weakness. The painful symptom is less expressed, and the difference in skin temperature with a healthy extremity does not exceed 2-3 °C. Total loss of sensitivity and a hyperesthesia are observed seldom. The clinic of thrombosis of arteries of this segment owing to an injury is similar that at an embolism.
Reasons of Thrombosis of peripheral arteries:
Acute thrombosis of arteries, as a rule, arises owing to disturbance of integrity of a vascular wall, change of system of a hemostasis and delay of a blood-groove. For this reason most often fibrinferments occur at the persons having cardiovascular diseases, obliterating atherosclerosis, a thromboangitis, diabetes mellitus. Development of thromboses is promoted by damages of walls of arteries at bruises of soft tissues, dislocations and fractures of bones of extremities, a compression of a vascular bundle by a tumor or a hematoma, and also various surgical interventions: angiographic researches, endovascular interventions, reconstructive operations on vessels and other intervention procedures. Besides, fibrinferments can arise against the background of some hematologic (hyperglobulia) and infectious (sapropyra) diseases. Response to damages of an endothelium of a vascular wall is adhesion and the subsequent aggregation of thrombocytes. The formed units tend to further growth that is connected with influence of a number of biologically active agents (cytokines, macrophages, neutrophilic leukocytes and thrombocytes). Intensity of a thrombogenesis substantially depends also on ability of an endothelium to produce aggregation inhibitors (nitrogen oxide, prostacyclin). At fibrinferment along with aggregation of thrombocytes there is an activation of coagulant system of blood and decrease in its fibrinolitic activity. Further on the surface of the unit fibrin threads, uniform elements of blood are adsorbed that finally promotes formation of a blood parcel – blood clot. Thrombosis can become widespread if the lytic link of system of a hemostasis is considerably oppressed.
Treatment of Thrombosis of peripheral arteries:
Character and content of treatment are defined by the reason of acute arterial impassability, a condition of blood circulation in an extremity and the general condition of the patient. In absolute majority of cases conservative therapy is not able to provide a complete recovery of an arterial blood-groove as it is not capable to lead to a full lysis of blood clot or an embolus. In this regard, at an embolism of bifurcation of an aorta, ileal, femoral, subclavial and humeral arteries an urgent reconstructive operative measure for the purpose of elimination of the reason of acute arterial impassability and recovery of an adequate blood-groove in the struck artery segment – an embolectomy, a thrombectomy, different types of angioplasty is shown. Steady recovery of an adequate blood-groove by means of modern surgical methods is reached at 70-95% of the operated patients. At the same time at emergence of initial symptoms of gangrene primary amputation of an extremity is shown.
