A CASE OF ACUTE ARTERIAL OBSTRUCTION IN WHICH MNMS WAS SUCCESSFULLY PREVENTED BY HEMOFILTRATION THROUGH THE AFFECTED LIMB DURING OPERATION

Our experience with a case of acute arterial obstruction, in which myonephropathic metabolic syndrome (MNMS) was successfully prevented by hemofiltration which was done from a vein of the affected limb during operation, is repoted. An 80-year-old woman was referred to the hospital because of acute arterial obstruction of the left lower limb. On admission ecchymotic cyanosis and a partial swelling of the muscle were noted in the left leg, and the urine was port wine colored. Since we feared for a possible risk of causing MNMS after regaining blood flow when a thrombectomy was employed for the case, cannulation was conducted for the vein of the affected limb before restoring blood flow during operation, followed by thrombectomy. In addition, a cross-bypass of the right and left common femoral arteries was conducted for an insufficient central arterial blood supply. There was no postoperative complication. The life of the patient was saved and the affected limb was also salvaged. We think that the method of conducting hemofiltration from a vein of the affected limb before restoration of blood flow during operation is a useful adjuvant procedure to prevent MNMS.