scholarly journals Acute Aortic Occlusion with Acute Onset of Paraplegia and Severe Hyposthenia

2020 ◽  
pp. 1-3
Author(s):  
Stefania Tamburrini ◽  
Daniela Viola ◽  
Fabio Spinetti ◽  
Giuseppe Mercogliano ◽  
Giuseppe Sarti ◽  
...  
Keyword(s):  
Lower Limb ◽  
Mesenteric Artery ◽  
Limb Ischemia ◽  
Acute Onset ◽  
Lower Limbs ◽  
Motor Deficit ◽  
Acute Limb Ischemia ◽  
Neurological Assessment ◽  
Bilateral Lower Limb ◽  
Acute Aortic Occlusion

A 75-years-old man presented at our ED with acute onset of paraplegia and severe bilateral lower limb hyposthenia. The patient ‘s neurological assessment was negative except for lower limbs positive Mingazzini test. CT angiography detected a complete lack of opacification of the abdominal aorta immediately below the emergency of the inferior mesenteric artery, caused by a coarse thrombus in the left ventricle. We present a case of acute aortic and lumbar arteries thrombosis with paraplegia and no clear symptoms of acute limb ischemia, in which the motor deficit in the lower extremities was explained by anterior spinal cord syndrome secondary to acute occlusion of lumbar arteries.

Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis – case report and systematic review of dabigatran use

VASA ◽  
2020 ◽  
pp. 1-6 ◽  
Author(s):  
Marina Di Pilla ◽  
Stefano Barco ◽  
Clara Sacco ◽  
Giovanni Barosi ◽  
Corrado Lodigiani
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Review Of The Literature ◽  
Heparin Induced Thrombocytopenia ◽  
Lower Limb Ischemia ◽  
Vein Thrombosis ◽  
Left Lower Limb

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

Giant cell arteriitis in critical bilateral lower limb ischemia

VASA ◽  
2013 ◽  
Vol 42 (5) ◽  
pp. 375-378 ◽  
Author(s):  
Magdalena Chudala ◽  
Katarzyna Drozdz ◽  
Pawel Gac ◽  
Tomasz Kuniej ◽  
Bozena Sapian-Raczkowska ◽  
...  
Keyword(s):  
Giant Cell ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Bilateral Lower Limb

scholarly journals A case of acute limb ischemia

2021 ◽  
Vol 8 (10) ◽  
pp. 1608
Author(s):  
Kshiti Rai ◽  
K. G. Sajeeth Kumar ◽  
Danish Ekkalayil ◽  
Anoop Chanthu K. K.
Keyword(s):  
Acute Myeloid Leukemia ◽  
Early Diagnosis ◽  
Lower Limb ◽  
Myeloid Leukemia ◽  
Hematological Malignancy ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Rare Presentation ◽  
Hematological Evaluation ◽  
Acute Myeloid

Thromboembolism is a well-recognized complication of hematological malignancy. The incidence of symptomatic thrombosis at diagnosis is relatively low in AML (acute myeloid leukemia) patients, though its incidence increases on treatment with anthracyclines. We reported a case of 69 year old female with T2DM who presented with DVT and later on acute limb ischemia of the same lower limb. On hematological evaluation, she had leukocytosis and thrombocytopenia. Further evaluation revealed AML. Thromboembolism as a rare presentation of AML in adults with leukemic hyperleukocytosis has seldom been reported. In the absence of clear guidelines, early diagnosis and management are desirable.

scholarly journals Analysis of associated diseases in patients with acute critical lower limb ischemia

2013 ◽  
Vol 66 (1-2) ◽  
pp. 41-45 ◽  
Author(s):  
Vladimir Manojlovic ◽  
Vladan Popovic ◽  
Dragan Nikolic ◽  
Djordje Milosevic ◽  
Janko Pasternak ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Lower Limb ◽  
Balloon Catheter ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Metabolic Decompensation ◽  
Arterial Embolism ◽  
Lower Limb Ischemia ◽  
Associated Diseases ◽  
Arterial Blood

Introduction. Acute critical lower limb ischemia refers to the state of severely impaired vitality of lower limbs due to acute occlusion of arterial blood vessel by a thrombus or emboli. Surgical revascularization in the first 6-12 hours after the onset of symptoms gives the best results. However, a high mortality rate and probability of limb loss make this problem more debatable, and can be related with associated diseases. Material and Methods. This research included 95 patients who had been operated within the first 12 hours after the onset of symptoms of critical limb ischemia. We collected the following data: age and sex of patients, etiology of limb ischemia, type of operation, associated diseases and outcome of treatment. Results and Discussion. Most of the patients were 70 to 80 years old, both sexes being equally represented. There was significantly more arterial embolism (70%) than thrombosis on the prior arterial lesion. Most of the embolizations were treated with Fogarty balloon catheter embolectomy (98%); however, a great number of arterial thrombosis demanded more complex ?inflow? and ?outflow? ensuring procedures such as thromboendarterectomy and bypass (33%). The performed surgical procedures showed no statistical differences when final outcome was analyzed. Amputation had to be performed in about 3% of the patients and all of them were diabetics. Mortality rate in this research was 10.5% and 7/10 with this outcome had severe form of chronic myocardiopathy and metabolic decompensation. Conclusion. Acute critical lower limb ischemia should be treated surgically as soon as possible. Negative outcomes are associated with comorbidity and general condition of the patient.

scholarly journals A rare case of sigmoid colon cancer in which the lower limbs received collateral blood flow from the inferior mesenteric artery owing to peripheral artery disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kyoichi Kihara ◽  
Hiromu Horie ◽  
Kozo Miyatani ◽  
Masayuki Endo ◽  
Tomoyuki Matsunaga ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Sigmoid Colon ◽  
Peripheral Artery Disease ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Sigmoid Colon Cancer ◽  
Peripheral Artery ◽  
Artery Disease

Abstract Background Colorectal cancer and peripheral artery disease are common conditions in older adults and may coexist in this population. Lymph node dissection along the inferior mesenteric artery is a vital procedure in cases of left-sided colorectal cancer. However, the inferior mesenteric artery may show a collateral blood pathway in rare cases of peripheral artery disease. We report a case of advanced sigmoid colon cancer in which the lower limbs received inferior mesenteric artery flow owing to asymptomatic peripheral artery disease. The possibility of catastrophic lower-limb ischemia because of complete mesenteric excision with ligation of the inferior mesenteric artery was a matter of concern in this case. Case presentation A 73-year-old man with asymptomatic peripheral artery disease was diagnosed with stage IIIB advanced sigmoid colon cancer. Angiography using a balloon-occlusion catheter revealed that his lower limbs received prominent inferior mesenteric artery blood flow through a collateral pathway. Therefore, interventional radiologists and cardiovascular surgeons evaluated the indications for endovascular stents or bypass grafts. The patient also had dilated cardiomyopathy, so the cardiovascular physicians evaluated his tolerance in the worst-case scenario of a colorectal anastomotic leak. The patient underwent axillofemoral artery bypass and two-stage laparoscopic sigmoid colectomy without anastomosis. The postoperative course was uneventful, and he resumed his job within a month after the resection. Conclusions Although collateral flow from the inferior mesenteric artery is rare in patients with peripheral artery disease, a few case reports have described fatal lower-limb ischemia following anterior resection. The perioperative multidisciplinary evaluation enabled us to understand the patient’s condition and risks, and allowed successful cancer treatment without ischemia of the lower limbs.

scholarly journals Acute Lower Limb Ischemia Secondary to COVID-19: A Case Report

2021 ◽  
Vol 11 (6) ◽  
pp. 161-163
Author(s):  
Komal Gharsangi ◽  
Rajesh Bhawani ◽  
Nitesh Kumar
Keyword(s):  
Lower Limb ◽  
Distress Syndrome ◽  
Multiorgan Failure ◽  
Clinical Manifestations ◽  
Limb Ischemia ◽  
Respiratory Illness ◽  
Acute Limb Ischemia ◽  
Poor Clinical Outcome ◽  
Rare Manifestation ◽  
Thrombotic Complications

COVID -19 is not just a respiratory illness; it is a great masquerader with clinical manifestations from pneumonia, acute respiratory distress syndrome to endothelial dysfunction, hypercoagulability and multiorgan failure. Thrombotic complications due to Covid related coagulopathy is of concern as it further leads to poor clinical outcome in severe cases of Covid 19. Acute limb ischemia (ALI) is a rare manifestation of Covid related coagulopathy. Key words: COVID, coagulopathy, acute limb ischemia (ALI).

scholarly journals Therapeutic Angiogenesis for Severely Ischemic Limbs — from Bench to Bedside in Acute Vascular Care

2017 ◽  
Vol 3 (4) ◽  
pp. 160-171
Author(s):  
Theodora Benedek ◽  
István Kovács ◽  
Imre Benedek
Keyword(s):  
Surgical Treatment ◽  
Limb Salvage ◽  
Arterial Occlusion ◽  
Limb Ischemia ◽  
Therapeutic Angiogenesis ◽  
Lower Limbs ◽  
Current Status ◽  
High Morbidity ◽  
Acute Limb Ischemia ◽  
Promising Alternative

Abstract Severe limb ischemia represents a critical condition, being associated with high morbidity and mortality rates. Patients with critical limb ischemia (CLI) require urgent initiation of interventional or surgical treatment, as restoration of the blood flow is the only way to ensure limb salvage in these critical cases. At the same time, in acute limb ischemia, a dramatic form of sudden arterial occlusion of the lower limbs, the integrity of the limb is also seriously threatened in the absence of urgent revascularization. From patients with CLI, 40% are “no option CLI”, meaning patients in whom, due to anatomical considerations or to the severity of the lesions, there is no possibility to perform interventional or surgical treatment or they have failed. Therapeutic angiogenesis has been proposed to serve as an effective and promising alternative therapy for patients with severe limb ischemia who do not have any other option for revascularization. This review aims to present the current status in therapeutic angiogenesis and the role of different approaches (gene or cell therapy, intra-arterial vs. intramuscular injections, different sources of cells) in increasing the rates of limb salvage in patients with severe ischemia of the lower limbs.

scholarly journals Adjunctive Ischemic Lower-Limb Perfusion during Aortic Repair with Cardiopulmonary Bypass Prevents Fatal Reperfusion Injury

2019 ◽  
Vol 46 (2) ◽  
pp. 130-132
Author(s):  
Kazuhiro Kurisu ◽  
Satoshi Kimura ◽  
Hiroshi Mitsuo ◽  
Yasutaka Ueno
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Reperfusion Injury ◽  
Lower Limb ◽  
Acute Aortic Dissection ◽  
Aortic Surgery ◽  
Kidney Injury ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Aortic Repair

Acute aortic dissection can be complicated by malperfusion syndromes, including ischemia of the lower limbs. In some cases, delayed correction of leg ischemia leads to reperfusion injury, potentially resulting in renal failure. We describe the case of a 64-year-old woman who presented with acute aortic dissection manifesting itself as lower-limb ischemia. During and after aortic surgery with cardiopulmonary bypass, the patient developed myonephropathic metabolic syndrome. Hyperkalemia was corrected and acute kidney injury was prevented by infusing large volumes of intravenous fluids and administering human atrial natriuretic peptide. Peripheral bypass surgery was unnecessary. This case suggests that restoring blood flow to an ischemic leg by means of adjunctive perfusion during aortic repair with cardiopulmonary bypass is a viable way to overcome the biochemical instability associated with prolonged ischemia, especially hyperkalemia in the early phase of reperfusion.

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