Management of acute limb ischemia related to underlying pheochromocytoma

Acute limb ischemia (ALI) related to pheochromocytoma is rare. We describe a 69-year-old woman who presented with ALI due to a thromboembolic phenomenon from new-onset atrial fibrillation that was successfully treated with intra-arterial catheter-directed lysis and systemic anticoagulation. Further...

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Bibliographic Details
Published in:Journal of vascular surgery cases and innovative techniques 2020-06, Vol.6 (2), p.272-276
Main Authors: Mederos, Michael A., Orr, Lauren E., Livhits, Masha J., Rigberg, David A.
Format: Article
Language:English
Subjects:
Acute limb ischemia
Case report
Hemorrhage
Lysis
Pheochromocytoma
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Summary:Acute limb ischemia (ALI) related to pheochromocytoma is rare. We describe a 69-year-old woman who presented with ALI due to a thromboembolic phenomenon from new-onset atrial fibrillation that was successfully treated with intra-arterial catheter-directed lysis and systemic anticoagulation. Further workup revealed a left adrenal mass and biochemical test results consistent with pheochromocytoma. The patient underwent a retroperitoneoscopic converted to open left adrenalectomy, splenectomy, and distal pancreatectomy because of severe inflammation in the retroperitoneum, probably from an adrenal or subcapsular renal hematoma secondary to systemic anticoagulation. Interval imaging before adrenalectomy for pheochromocytoma should be considered after thrombolysis and anticoagulation for ALI.
ISSN:2468-4287
2468-4287
DOI:10.1016/j.jvscit.2020.03.012