Document Detail


"HIT on Trousseau" double trouble: acquired coagulopathy with femoral artery thrombosis.
MedLine Citation:
PMID:  18690597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Trousseau Syndrome is a paraneoplastic procoagulant phenomenon. Heparin-induced thrombocytopenia (HIT) is a rare complication of anticoagulation with heparin. To our knowledge, the coincidence of the two has not been reported so far. We report a case of an acute thrombosis of the left femoral artery and distal leg arteries in a patient with an otherwise normal cardiovascular status. Endovascular revascularization attempts using mechanical rotational thrombectomy catheter, aspiration and local thrombolysis were unsuccessful. Progressive coagulation along the intra-arterial catheter was seen. Surgical thrombectomy of the femoral-pedal axis was successful, but the patient developed an immune-mediated HIT postoperatively. An adenocarcinoma of the colon was the likely cause for the initial arterial thrombosis, and probably adversely affected endovascular revascularization attempts. Subsequent HIT with microvascular thrombosis worsened ischemic damage leading to a below knee-amputation, despite patent large vessels. Compared to venous thrombosis, arterial thrombosis is a rare manifestation of Trousseau syndrome. The coincidence of it with HIT is even rarer. There may be a causal relationship between the two.
Authors:
C Warncke; L Alberio; H Savolainen; R von Allmen; I Baumgartner; M Husmann
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  VASA. Zeitschrift für Gefässkrankheiten     Volume:  37     ISSN:  0301-1526     ISO Abbreviation:  VASA     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-11     Completed Date:  2008-10-16     Revised Date:  2012-10-19    
Medline Journal Info:
Nlm Unique ID:  0317051     Medline TA:  Vasa     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  281-4     Citation Subset:  IM    
Affiliation:
Division of Angiology and Vascular Surgery, Cardiovascular Department, Inselspital Bern, University Hospital and University of Bern, Switzerland. cornelius.warncke@insel.ch
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma, Mucinous / complications*,  pathology,  surgery
Amputation
Anticoagulants / adverse effects*
Arterial Occlusive Diseases / etiology*,  radiography,  therapy
Colectomy
Colonic Neoplasms / complications*,  pathology,  surgery
Colonoscopy
Embolectomy
Femoral Artery* / radiography,  surgery
Heparin / adverse effects*
Humans
Male
Middle Aged
Paraneoplastic Syndromes / etiology*,  radiography,  therapy
Suction
Thrombectomy
Thrombocytopenia / chemically induced*,  therapy
Thrombolytic Therapy
Thrombosis / etiology*,  radiography,  therapy
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 9005-49-6/Heparin

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