1/84. Developing venous gangrene in deep vein thrombosis: intraarterial low-dose burst therapy with urokinase--case reports.Two patients with developing venous gangrene of the lower extremity and contraindications to systemic thrombolytic therapy are presented. Low-dose intraarterial burst therapy with urokinase provided rapid amelioration of symptoms and avoided amputation without any serious bleeding complications in both patients.- - - - - - - - - - ranking = 1keywords = thrombosis (Clic here for more details about this article) |
2/84. Multicentric warfarin-induced skin necrosis complicating heparin-induced thrombocytopenia.Two patients developed catastrophic multicentric skin necrosis while receiving warfarin to treat venous thromboembolism complicated by immune-mediated heparin-induced thrombocytopenia (HIT). Patient 1 developed skin necrosis involving the breasts, thighs, and face, as well as venous limb gangrene and bilateral hemorrhagic necrosis of the adrenal glands, resulting in death. The second patient developed bilateral mammary necrosis necessitating mastectomies, as well as skin necrosis involving the thigh. Neither patient had an identifiable hypercoagulable syndrome, other than HIT. HIT may represent a risk factor for the development of multicentric warfarin-induced skin necrosis (WISN).- - - - - - - - - - ranking = 0.0073371851240457keywords = embolism (Clic here for more details about this article) |
3/84. A fatal case of craniofacial necrotizing fasciitis.A case of fatal craniofacial necrotizing fasciitis is described in a 72-year-old diabetic woman and management is discussed. Progressive infection of the eyelids occurred with involvement of the right side of the face. Computed tomography revealed soft tissue swelling. Antibiotic treatment was started and debridement performed; histopathology showed acute inflammation and thrombosis of the epidermis and dermis. Despite treatment, scepticemia occurred, resulting in death less than 48 h after presentation. At this time extensive necrosis had developed in the superficial fascia with undermining and gangrene of surrounding tissues. Streptococcus and staphylococcus were the pathogens involved. Poor prognosis in similar patients has been associated with extensive infection, involvement of the lower face and neck, delayed treatment, advanced age, diabetes and vascular disease.- - - - - - - - - - ranking = 0.25keywords = thrombosis (Clic here for more details about this article) |
4/84. Venous gangrene in a patient with adenocarcinoma of the lung.Cancer-related thromboembolism is a severe but not uncommon paraneoplastic syndrome in mucinous cancer patients. However, cancer-induced venous gangrene is extremely rare and has never been reported in the English literature. Here, we present a case of lung cancer complicated with venous gangrene of the left foot. An elevated serum anticardiolipin level was detected during hospitalization, but the patient's clinical condition stabilized after heparinization. We suggest that in cancer patients, an elevated serum anticardiolipin antibody level might be a warning sign of an impending thrombotic event and that low-molecular-weight heparin is a sensible choice in treating this kind of cancer-related thromboembolism.- - - - - - - - - - ranking = 0.014674370248091keywords = embolism (Clic here for more details about this article) |
5/84. Peripheral gangrene complicating idiopathic and recessive hemolytic uremic syndromes.Three patients with hemolytic uremic syndrome (HUS) developed peripheral gangrene. Bilateral carotid artery thromboses occurred in one of these patients after recovery from HUS. One patient had a long history of juvenile rheumatoid arthritis. In the second patient, a flu-like illness preceded the onset of HUS. The third was one of two sisters, with the HUS appearing more than 1 year apart. None had evidence of disseminated intravascular coagulation or infection with streptococcus pneumoniae. The patient with rheumatoid arthritis had renal cortical necrosis but recovered moderate renal function after treatment with dialysis and plasmapheresis for 6 months. The child with a genetic form of HUS died of renal failure and had massive cortical necrosis and vascular thrombosis at autopsy. This is the first report of peripheral gangrene in children with idiopathic HUS and autosomal recessive HUS.- - - - - - - - - - ranking = 0.25keywords = thrombosis (Clic here for more details about this article) |
6/84. Upper extremity venous gangrene following coronary artery bypass. A case report and review of the literature.Acute symptomatic upper extremity deep vein thrombosis (DVT) are estimated to account for only 2-4% of all deep vein thrombosis. Upper extremity DVT leading to phlegmasia cerulea dolens (PCD) occurs in an estimated 2-5% of these cases. Progression of PCD to venous gangrene is extremely rare with only 16 previously reported cases in the literature. Only 7 of the cited cases document significant tissue loss. This report describes a 61-year-old male who developed upper extremity DVT complicated by PCD which led to venous gangrene and limb loss.- - - - - - - - - - ranking = 0.5keywords = thrombosis (Clic here for more details about this article) |
7/84. Venous limb gangrene during warfarin treatment of cancer-associated deep venous thrombosis.BACKGROUND: The cause of cancer-associated venous limb gangrene is unknown but could paradoxically be due to warfarin. OBJECTIVE: To determine the pathogenesis of venous gangrene in a patient with cancer. DESIGN: Case report. SETTING: University hospital in ontario, canada. PATIENT: 66-year-old woman with metastatic lung cancer and deep venous thrombosis. MEASUREMENTS: Levels of vitamin k-dependent factors, additional coagulation factors, and thrombin-antithrombin complexes (marker of thrombin generation). RESULTS: During warfarin use, venous limb gangrene developed when the international normalized ratio (INR) reached 6.0 (therapeutic range, 2.0 to 3.0); at this time, the level of protein c (a vitamin k-dependent natural anticoagulant) was severely reduced, but thrombin-antithrombin complexes remained markedly elevated. The supratherapeutic INR was explained by the greatly reduced levels of factor vii, which correlated closely with protein c levels; therefore, the high INR was a surrogate marker for severely reduced protein c activity. CONCLUSION: warfarin may contribute to the pathogenesis of cancer-associated venous limb gangrene by leading to severe depletion of protein c while at the same time failing to reduce thrombin generation.- - - - - - - - - - ranking = 1.25keywords = thrombosis (Clic here for more details about this article) |
8/84. Arterial thrombosis in scleroderma.Clinical and pathological observations are presented on five patients with scleroderma who developed thrombosis of a major vessel. Three died following intestinal infarction or limb gangrene and two had digit or extremity amputation. Severe intimal thickening of major arteries with thrombus formation was noted but no significant abnormality was found in the clotting activity of the blood. Histochemical studies in three cases suggested a reduction of fibrinolytic activity at the site of thrombosis in the diseased vessels. These studies support the view that the vascular system is profoundly altered in scleroderma and may play an important role in some manifestations of the disease.- - - - - - - - - - ranking = 1.5keywords = thrombosis (Clic here for more details about this article) |
9/84. Venous limb gangrene during overlapping therapy with warfarin and a direct thrombin inhibitor for immune heparin-induced thrombocytopenia.We report two patients with deep-vein thrombosis complicating immune heparin-induced thrombocytopenia who developed venous limb gangrene during overlapping therapy with a direct thrombin inhibitor (lepirudin or argatroban) and warfarin. In both patients, therapy with the direct thrombin inhibitor was interrupted during persisting severe athrombocytopenia while warfarin administration continued. Both patients exhibited the typical feature of a supratherapeutic international normalized ratio (INRs, 5.9 and 7.3) that has been linked previously with warfarin-associated venous limb gangrene. These data suggest that warfarin anticoagulation be postponed in patients with acute heparin-induced thrombocytopenia until substantial recovery of the platelet count has occurred.- - - - - - - - - - ranking = 0.25keywords = thrombosis (Clic here for more details about this article) |
10/84. Bilateral renal vein thrombosis as a complication of gangrenous appendicitis.Bilateral renal vein thrombosis after an appendectomy has never been reported in the pediatric literature. We describe the case of a 10-year-old boy who developed this very unusual complication following appendectomy for gangrenous appendicitis with peritonitis. color duplex Doppler is the most appropriate investigation to allow correct diagnosis and immediate medical treatment. peritoneal dialysis is a simple and effective tool to prevent permanent damage to renal function.- - - - - - - - - - ranking = 1.25keywords = thrombosis (Clic here for more details about this article) |
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