Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases
Abstract Background Acute limb ischemia (ALI) and critical limb ischemia (CLI) following ALI are life-threatening diseases. The rare potential causes of ALI include hypercoagulable state diseases, such as antiphospholipid syndrome (APS) and essential thrombocythemia (ET). Hypercoagulability often ma...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-09-01
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| Series: | CVIR Endovascular |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s42155-020-00166-7 |
| _version_ | 1811327063234183168 |
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| author | Keisuke Shoji Kan Zen Kenji Yanishi Noriyuki Wakana Naohiko Nakanishi Takeshi Nakamura Satoaki Matoba |
| author_facet | Keisuke Shoji Kan Zen Kenji Yanishi Noriyuki Wakana Naohiko Nakanishi Takeshi Nakamura Satoaki Matoba |
| author_sort | Keisuke Shoji |
| collection | DOAJ |
| description | Abstract Background Acute limb ischemia (ALI) and critical limb ischemia (CLI) following ALI are life-threatening diseases. The rare potential causes of ALI include hypercoagulable state diseases, such as antiphospholipid syndrome (APS) and essential thrombocythemia (ET). Hypercoagulability often make revascularization for arterial occlusion, especially associated with infrapopliteal lesions, difficult. This is because the vessels have poor run-off, and elevated peripheral vascular resistance associated with microcirculation failure, due to a high thrombus burden. There is no established treatment for this issue. Case presentation A 45 years-old and a 56 years-old male suffered from thrombotic arterial occlusion as a first manifestation of APS and ET, respectively. Combination therapy with aggressive anti-thrombotic therapy and revascularization, such as endovascular therapy and surgical thrombectomy based on the angiosome concept, was performed. However, the high thrombus burden caused a poor pedal outflow, and significant limb ischemia remained. Additional pedal artery angioplasty was performed to improve residual limb ischemia in each case and provided sufficient blood flow to the foot. Conclusion The pedal artery angioplasty for thrombotic pedal artery occlusion cases, associated with hypercoagulable state diseases, seems to be a treatment option for relieving residual limb ischemia. |
| first_indexed | 2024-04-13T15:01:08Z |
| format | Article |
| id | doaj.art-5e91a359beea4ee5b670a4723eeb51d3 |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-04-13T15:01:08Z |
| publishDate | 2020-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-5e91a359beea4ee5b670a4723eeb51d32022-12-22T02:42:18ZengSpringerOpenCVIR Endovascular2520-89342020-09-01311510.1186/s42155-020-00166-7Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseasesKeisuke Shoji0Kan Zen1Kenji Yanishi2Noriyuki Wakana3Naohiko Nakanishi4Takeshi Nakamura5Satoaki Matoba6Department of Cardiovascular Medicine, Kyoto Prefectural University of MedicineDepartment of Cardiovascular Medicine, Kyoto Prefectural University of MedicineDepartment of Cardiovascular Medicine, Kyoto Prefectural University of MedicineDepartment of Cardiovascular Medicine, Kyoto Prefectural University of MedicineDepartment of Cardiovascular Medicine, Kyoto Prefectural University of MedicineDepartment of Cardiovascular Medicine, Kyoto Prefectural University of MedicineDepartment of Cardiovascular Medicine, Kyoto Prefectural University of MedicineAbstract Background Acute limb ischemia (ALI) and critical limb ischemia (CLI) following ALI are life-threatening diseases. The rare potential causes of ALI include hypercoagulable state diseases, such as antiphospholipid syndrome (APS) and essential thrombocythemia (ET). Hypercoagulability often make revascularization for arterial occlusion, especially associated with infrapopliteal lesions, difficult. This is because the vessels have poor run-off, and elevated peripheral vascular resistance associated with microcirculation failure, due to a high thrombus burden. There is no established treatment for this issue. Case presentation A 45 years-old and a 56 years-old male suffered from thrombotic arterial occlusion as a first manifestation of APS and ET, respectively. Combination therapy with aggressive anti-thrombotic therapy and revascularization, such as endovascular therapy and surgical thrombectomy based on the angiosome concept, was performed. However, the high thrombus burden caused a poor pedal outflow, and significant limb ischemia remained. Additional pedal artery angioplasty was performed to improve residual limb ischemia in each case and provided sufficient blood flow to the foot. Conclusion The pedal artery angioplasty for thrombotic pedal artery occlusion cases, associated with hypercoagulable state diseases, seems to be a treatment option for relieving residual limb ischemia.http://link.springer.com/article/10.1186/s42155-020-00166-7Pedal artery angioplastyThrombotic artery occlusionHypercoagulable state diseaseCritical limb ischemiaAcute limb ischemia |
| spellingShingle | Keisuke Shoji Kan Zen Kenji Yanishi Noriyuki Wakana Naohiko Nakanishi Takeshi Nakamura Satoaki Matoba Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases CVIR Endovascular Pedal artery angioplasty Thrombotic artery occlusion Hypercoagulable state disease Critical limb ischemia Acute limb ischemia |
| title | Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases |
| title_full | Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases |
| title_fullStr | Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases |
| title_full_unstemmed | Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases |
| title_short | Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases |
| title_sort | two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases |
| topic | Pedal artery angioplasty Thrombotic artery occlusion Hypercoagulable state disease Critical limb ischemia Acute limb ischemia |
| url | http://link.springer.com/article/10.1186/s42155-020-00166-7 |
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