Arterial Embolism to the Upper Extremity in a Patient with Factor V Leiden Mutation (APC Resistance)
| Autor: | Achim Neufang, Walther Schmiedt, H. Schinzel, Bernhard Dorweiler, H. Oelert, W. Kasper-Koenig |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Arterial embolism medicine.medical_treatment Embolectomy 030204 cardiovascular system & hematology Fingers 03 medical and health sciences 0302 clinical medicine Embolus Ischemia Thromboembolism medicine.artery medicine Factor V Leiden Humans Radial artery Activated Protein C Resistance medicine.diagnostic_test biology business.industry Factor V medicine.disease Capillary refill Surgery Radiography body regions 030104 developmental biology Thumb Embolism Radial Artery biology.protein Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Angiology. 54:125-130 |
| ISSN: | 1940-1574 0003-3197 |
| Popis: | Factor V Leiden mutation has emerged as one of the leading abnormalities in inherited blood coagulation disorders, resulting in a markedly increased risk for deep leg vein thrombosis. A 24- year-old woman presented with acute onset of critical ischemia of her left thumb and index finger. Intraarterial angiography revealed an embolus in the distal radial artery and a thrombotic occlusion of the digital artery of the thumb and index finger. Immediate therapy encompassed a selective surgical embolectomy of the distal radial artery followed by a local intraarterial lysis that was continued for 3 days. Additionally, therapeutic anticoagulation and vasodilating drugs (prostaglandin E) were administered. Within 2 days, capillary refill reappeared and the initial loss of sensory function at the tip of the thumb and index finger diminished. A screening test for thrombophilic disorders led to the diagnosis of a heterozygous mutation of factor V (Leiden mutation). Arterial thromboembolic events of factor V Leiden mutation are rare and have to date been described only in the supraaortic and coronary circulation. Therefore, the arterial embolism to the left hand presented in this report constitutes a rarity that could be successfully salvaged by the combined use of a vascular surgical procedure and intensified medical management. |
| Databáze: | OpenAIRE |
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