Digital ischemia and gangrene due to red blood cell aggregation induced by acquired dysfibrinogenemia Hau C. Kwaan, MD, Murray Levin, MD, Shumpei Sakurai,

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Presentation transcript:

Digital ischemia and gangrene due to red blood cell aggregation induced by acquired dysfibrinogenemia Hau C. Kwaan, MD, Murray Levin, MD, Shumpei Sakurai, MD, Omer Kucuk, MD, Michael W. Rooney, PhD, Leonard J. Lis, PhD, John W. Kauffman, PhD Journal of Vascular Surgery Volume 26, Issue 6, Pages 1061-1068 (December 1997) DOI: 10.1016/S0741-5214(97)70021-1 Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Ischemic changes in patient's digits are shown, with gangrene of two fingers in his left hand. Journal of Vascular Surgery 1997 26, 1061-1068DOI: (10.1016/S0741-5214(97)70021-1) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Arteriogram of patient's upper limbs shows bilaterally poor filling of palmar arch and absence of blood flow beyond the level of the first interphalangeal joints (A, left hand; B, left elbow; C, left shoulder; D, right hand; E, right elbow; F, right shoulder). Journal of Vascular Surgery 1997 26, 1061-1068DOI: (10.1016/S0741-5214(97)70021-1) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Arteriogram of patient's upper limbs shows bilaterally poor filling of palmar arch and absence of blood flow beyond the level of the first interphalangeal joints (A, left hand; B, left elbow; C, left shoulder; D, right hand; E, right elbow; F, right shoulder). Journal of Vascular Surgery 1997 26, 1061-1068DOI: (10.1016/S0741-5214(97)70021-1) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Arteriogram of patient's upper limbs shows bilaterally poor filling of palmar arch and absence of blood flow beyond the level of the first interphalangeal joints (A, left hand; B, left elbow; C, left shoulder; D, right hand; E, right elbow; F, right shoulder). Journal of Vascular Surgery 1997 26, 1061-1068DOI: (10.1016/S0741-5214(97)70021-1) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Arteriogram of patient's upper limbs shows bilaterally poor filling of palmar arch and absence of blood flow beyond the level of the first interphalangeal joints (A, left hand; B, left elbow; C, left shoulder; D, right hand; E, right elbow; F, right shoulder). Journal of Vascular Surgery 1997 26, 1061-1068DOI: (10.1016/S0741-5214(97)70021-1) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Arteriogram of patient's upper limbs shows bilaterally poor filling of palmar arch and absence of blood flow beyond the level of the first interphalangeal joints (A, left hand; B, left elbow; C, left shoulder; D, right hand; E, right elbow; F, right shoulder). Journal of Vascular Surgery 1997 26, 1061-1068DOI: (10.1016/S0741-5214(97)70021-1) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Arteriogram of patient's upper limbs shows bilaterally poor filling of palmar arch and absence of blood flow beyond the level of the first interphalangeal joints (A, left hand; B, left elbow; C, left shoulder; D, right hand; E, right elbow; F, right shoulder). Journal of Vascular Surgery 1997 26, 1061-1068DOI: (10.1016/S0741-5214(97)70021-1) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Cover-slip preparation of patient's blood shows rouleaux formation in long chains. Journal of Vascular Surgery 1997 26, 1061-1068DOI: (10.1016/S0741-5214(97)70021-1) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Representative Raman spectra of patient's fibrinogen (A) and normal fibrinogen (B) in phosphate-buffered saline solution shows comparisons of respective tracings ranging from 716 to 1800 cm–1. Journal of Vascular Surgery 1997 26, 1061-1068DOI: (10.1016/S0741-5214(97)70021-1) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions