Small Incision Fasciotomy in a Patient with Compartment Syndrome and Peripheral Arterial Occlusive Disease

  • Hori Daijiro
    Department of Cardiovascular Surgery, Showa University, Fujigaoka Hospital, Kanagawa, Japan
  • Noguchi Kenichiro
    Department of Cardiovascular Surgery, Showa University, Fujigaoka Hospital, Kanagawa, Japan
  • Nomura Yohei
    Department of Cardiovascular Surgery, Showa University, Fujigaoka Hospital, Kanagawa, Japan
  • Lefor Alan
    Department of Surgery, Jichi Medical University, Tochigi, Japan
  • Tanaka Hiroyuki
    Department of Cardiovascular Surgery, Showa University, Fujigaoka Hospital, Kanagawa, Japan

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An 82-year-old-man with a previous history of atrial fibrillation was admitted with acute limb ischemia. Emergent embolectomy was performed, but after the operation, the patient suffered from recurrent ischemic pain. Peripheral angiography revealed thrombosis of the distal popliteal artery due to pre-existing peripheral arterial occlusive disease. Bypass surgery of the popliteal artery and posterior tibial artery was then performed. Although peripheral blood flow was restored after the operation, he suffered from compartment syndrome the next day. The patient was treated with an emergent bed-side fasciotomy using a small incision, achieving full recovery of blood flow to the distal artery. The wound closed secondarily without surgical closure. In a patient with peripheral arterial occlusive disease, fasciotomy should be performed at a lower compartment pressure due to a lack of peripheral perfusion pressure. Emergent small incision fasciotomy was effective in this patient with an acute compartment syndrome and an ischemic limb.

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