1/7. thromboembolism complicating thrombin injection of femoral artery pseudoaneurysm: management with intraarterial thrombolysis.Ultrasound (US)-guided compression of pseudoaneurysms is being rapidly replaced by US-guided percutaneous treatment with thrombin injection because of the less intensive nature of this procedure. thromboembolism after percutaneous treatment with thrombin injection is rare and has been described in brachial artery pseudoaneurysms. These were managed with intravenous administration of heparin and surgical thrombectomy. In this report, the authors describe thromboembolic complication of thrombin injection after treatment of a femoral artery pseudoaneurysm. This was managed by intraarterial thrombolysis with use of recombinant tissue plasminogen activator (rt-PA) with resolution of all major occlusive changes. A lower dose of thrombin injection and frequent postprocedural monitoring of distal pulses is recommended.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/7. Fatal tumor thrombosis due to an inferior vena cava leiomyosarcoma in a patient with antiphospholipid antibody syndrome.We describe a patient with antiphospholipid antibody syndrome (APS) who died because of relentless inferior vena cava (IVC) tumor thrombosis due to an unsuspected leiomyosarcoma. Laboratory confirmation for APS was provided by functional identification of a lupus anticoagulant and anticardiolipin IgG and anti-beta2-glycoprotein I IgM antibodies. Although sensitive for detecting vascular obstruction, radiocontrast venography and magnetic resonance imaging and angiography detected the IVC thrombosis but failed to distinguish its malignant nature. Concomitant refractory thrombocytopenia prevented further invasive diagnostic and therapeutic maneuvers for progressive, severe IVC thrombosis unresponsive to aggressive treatment of APS. Deep venous thrombosis refractory to anticoagulant and immunomodulatory therapies in a patient with APS may be due to a concomitant underlying malignancy, such as a leiomyosarcoma, causing vascular obstruction.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/7. Cryofibrinogenemia: report of a case.Cryofibrinogenemia, a rare disease, is diagnosed by the presence of reversible cryoprecipitate in plasma, which may cause various clinical manifestations of thromboembolic or hemorrhagic disorders. A 66-year-old female patient suffered from recurrent reticulate erythema, purpura and gangrene on the distal portion of the extremities and face during the winter for 5 years. Cryofibrinogenemia was proven with the following evidences: (1) Histopathologic findings revealed many eosinophilic cylinders, about 6-9 microns in diameter, deposited within the lumen of the blood vessels in the dermis and subcutaneous tissue. There was no evidence of vasculitis. These cylinders were fibrinogen in nature, as proven by direct immunofluorescence. (2) Cryofibrinogen was detected in the citrated plasma, which was confirmed by double immunodiffusion, the presence of an IgG-kappa M protein was also revealed by immunofixation. debridement and skin grafts were performed, and prednisolone combined with cyclophosphamide were given. skin lesions improved without recurrence, and the "cryocrit" decreased from 13.6% to less than 2% during the follow up. We conclude that if there is any case with the similar cutaneous manifestations, cryofibrinogenemia should be considered.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/7. Myointimal hyperplasia as a result of balloon-catheter thromboembolectomy.The balloon-tipped embolectomy catheter is widely utilized in the treatment of arterial thromboemboli, significantly improving mortality and limb salvage rates. However, early and late complications related to catheter-tip injury and balloon trauma continue to occur and compromise the results of surgical intervention. Myointimal hyperplasia is an example of an unusual late complication induced by balloon-related arterial wall trauma. Myointimal hyperplasia is a commonly recognized healing response of the arterial wall to endothelial injury but is rarely reported after balloon-catheter thromboembolectomy. The extensive nature of the injury increases the incidence of limb loss. The pathophysiologic nature of this process is reviewed, and pertinent structural details such as intimal thickening and disruption of the internal elastic lamina are presented. The pathogenesis of myointimal hyperplasia suggests guidelines for catheter use during embolectomy that may further reduce the incidence of this unusual complication.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
5/7. Serious complications of congenital antithrombin iii (AT III) deficiency in a 7-year-old girl.A 7-year-old gypsy girl developed venous and arterial thromboembolism. In this case AT III deficiency of hereditary nature was demonstrated as the cause of thromboembolism.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/7. Postpartum acute myocardial infarction: a rare occurrence of uncertain etiology.Two women who had an acute myocardial infarction during the early postpartum period are described, and the findings in nine other women previously reported on are summarized. attention is called to the atypical nature of ischemic heart disease and myocardial infarction in these patients when compared with myocardial infarction during pregnancy and with ischemic heart disease in men. Postpartum infarcts most often occur in women in their 20s during their first pregnancy, frequently a pregnancy complicated by the preeclampsia-eclampsia syndrome, and are associated with a high mortality rate. In one of our patients and one patient previously reported on, the results of coronary arteriography were normal, suggesting that coronary arterial thromboembolism or spasm was a cause of the infarction. Because postpartum myocardial infarction may be unrelated to atherosclerotic narrowing, detailed angiographic studies in such patients appear warranted. These cases indicate the variety and complexity of ischemic heart disease in women.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/7. Antiphospholipid antibody syndrome associated with ovarian cancer. A new paraneoplastic syndrome?We describe a 41-year-old woman, in whom antiphospholipid antibody syndrome (APS) occurred at presentation, before the detection of an ovarian endometrial adenocarcinoma. This syndrome was characterized by widespread and worsening thromboembolism and it did not respond to conventional anticoagulant treatment. The paraneoplastic nature of this APS was strongly suggested by the disappearance of both thromboembolism and antiphospholipid antibodies only after surgical removal of the cancer.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |