"HIT on Trousseau" double trouble: acquired coagulopathy with femoral artery thrombosis

Warncke, C; Alberio, L; Savolainen, H; von Allmen, R; Baumgartner, I; Husmann, M (2008). "HIT on Trousseau" double trouble: acquired coagulopathy with femoral artery thrombosis. Vasa - European journal of vascular medicine, 37(3), pp. 281-4. Bern: Huber 10.1024/0301.1526.37.3.281

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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.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

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04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Warncke, Cornelius; Alberio, Lorenzo; Baumgartner, Iris and Husmann, Marc

ISSN:

0301-1526

ISBN:

281-4

Publisher:

Huber

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:02

Last Modified:

04 May 2014 23:18

Publisher DOI:

10.1024/0301.1526.37.3.281

Web of Science ID:

000259576000011

URI:

https://boris.unibe.ch/id/eprint/26889 (FactScience: 91621)

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