Superficial femoral artery thrombosis as a cause for distal embolism in primary antiphospholipid syndrome

• Published in: Journal of vascular surgery 2008-08, Vol.48 (2), p.472-477
• Main Authors: Lauvao, Lannery S., MD, Goshima, Kaoru R., MD, Leon, Luis R., MD, RVT, Nolan, Paul E., PharmD, Hughes, John D., MD
• Format: Article
• Language: English
• Subjects: Adult; Antiphospholipid Syndrome - complications; Antiphospholipid Syndrome - diagnosis; Antiphospholipid Syndrome - drug therapy; Arterial Occlusive Diseases - complications; Arterial Occlusive Diseases - diagnosis; Biological and medical sciences; Blue Toe Syndrome - etiology; Blue Toe Syndrome - therapy; Femoral Artery; Follow-Up Studies; Hematologic and hematopoietic diseases; Humans; Male; Medical sciences; Platelet diseases and coagulopathies; Radiography; Reconstructive Surgical Procedures - methods; Risk Assessment; Severity of Illness Index; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thrombectomy - methods; Thrombosis - diagnostic imaging; Thrombosis - surgery; Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Warfarin - therapeutic use
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2008.02.052

Antiphospholipid syndrome is a diagnosis with the clinical manifestations of thromboses in the presence of an antiphospholipid antibody. A 25-year-old man with a history of deep venous thrombosis, pulmonary emboli, and myocardial infarction, and receiving long-term anticoagulation with warfarin, all due to primary antiphospholipid syndrome, presented with blue toe syndrome from a primary superficial femoral artery thrombus. He was anticoagulated with fondaparinux in addition to dipyridamole and aspirin perioperatively. The area of thrombus was resected and reconstructed using a cephalic vein interposition graft. This report reviews antiphospholipid syndrome and identifies potential questions and problems relating to a rare clinical presentation.