Superficial femoral artery thrombosis as a cause for distal embolism in primary antiphospholipid syndrome Lannery S. Lauvao, MD, Kaoru R. Goshima, MD,

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Presentation transcript:

Superficial femoral artery thrombosis as a cause for distal embolism in primary antiphospholipid syndrome Lannery S. Lauvao, MD, Kaoru R. Goshima, MD, Luis R. Leon, MD, RVT, Paul E. Nolan, PharmD, John D. Hughes, MD Journal of Vascular Surgery Volume 48, Issue 2, Pages 472-477 (August 2008) DOI: 10.1016/j.jvs.2008.02.052 Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 1 Left, An active venous stasis ulcer is shown affecting the pretibial area of our patient. Right, Punctate ulcers are shown affecting the left first and fifth toes. The left third and forth toes had tender, flat, punctate bluish discolored lesions, likely precursors of ulcers, in the context of normal distal pulses. Journal of Vascular Surgery 2008 48, 472-477DOI: (10.1016/j.jvs.2008.02.052) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 2 Angiography of the left lower extremity shows a smooth filling defect affecting the middle third of the superficial femoral artery, thought to be the culprit of the distal embolic phenomenon. The normal appearance of the rest of the artery and the lack of collateral vessels are noteworthy, confirming the lack of atherosclerosis as an etiologic factor for this patient's complaints. Journal of Vascular Surgery 2008 48, 472-477DOI: (10.1016/j.jvs.2008.02.052) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 3 Left, Intraoperative photograph shows the lumen of the left superficial femoral artery at its distal third demonstrating organized thrombus and periarterial fibrosis. No periarterial calcification or intimal thickening was evident upon surgical manipulation. Right, The photograph shows the final appearance of the cephalic vein interposition graft. Journal of Vascular Surgery 2008 48, 472-477DOI: (10.1016/j.jvs.2008.02.052) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 4 Histopathologic section of arterial vessel wall shows thrombus without evidence for atherosclerosis. Hemotoxylin and eosin staining, ×40 original magnification. Journal of Vascular Surgery 2008 48, 472-477DOI: (10.1016/j.jvs.2008.02.052) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions