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Objectives: Acute lower extremity ischemia is a rapidly progressive condition that could stem from embolism or thrombus, leading to sudden interruption of blood flow which might cause loss of limb or even mortality. In this study, the registries of the patients having acute lower limb ischemia who has previously undergone femoral embolectomy in our center were assessed, retrospectively. Additionally, relevant literature on this topic were reviewed. Materials and Methods: The data were obtained from the hospital records of 18 patients with acute lower limb arterial thrombosis ischemia who have undergone femoral artery thromboembolectomy between January 2011 and January 2017. Results: The age range of 61.1% of the patients is between 65 and 84. 1-month, 6-month, and 1-year mortality rates of the patients are 16.67%, 27.78% and 50%, respectively. A significant portion of the patients having acute lower limb ischemia has a concomitant systemic atherosclerotic disorder in the pre-operative period. High mortality and morbidity rates occur as a result of coexisting medical comorbidities of patients with acute lower limb ischemia (ALLI). Conclusion: It is crucial to take various risk factors, such as hypertension, diabetes, atrial fibrillation under control and start an immediate treatment for the prevention of multiorgan failure in the case of acute lower limb ischemia.

Abstract:Cetuximab is a monoclonal drug that has survival advantage in the treatment of patients with locoregionally advanced and platinum-refractory metastatic or recurrent head and neck squamous cell carcinoma (SCC). We report a case of 52 year-old man with peristomal recurrence of laryngeal SCC patient who was treated successfully with cetuximab, cisplatin and 5FU after organ preservation treatment and surgery. The patient presented with dysphonia and laryngeal lesions, underwent direct laryngoscopy (DL) with biopsies and the diagnosis was poorly differentiated SCC. Subsequently, he was treated with chemoradiation therapy. However, he developed hoarseness and dyspnea after chemoradiation. DL was performed due to transglottic lesion with suspicious left level 2A lymph node metastasis. Then, we performed total laryngectomy with neck dissection. Unfortunately, pharyngocutaneous fistula and peristomal recurrence developed after the surgery. The patient received palliative chemotherapy with cetuximab, cisplatin, and 5FU and acheived complete remission. Pharyngocutaneous fistula was closed with deltopectoral fasciocutaneous flap. No signs of recurrence were noted at 18 months followup. Concurrent therapy with cetuximab may be beneficial in patients with recurrent laryngeal cancer.