Acute Limb-Threatening Ischemia Associated With Antiphospholipid Syndrome: A Report of Two Cases

Surgical Interventions for Organ and Limb Ischemia Associated With Primary and Secondary Antiphospholipid Antibody Syndrome With Arterial Involvement

“…With respect the conduits, we agree with Lauvao et al in the recommendation of the use of autogenous grafts when possible and a strict perioperative and long-term anticoagulation to prevent graft failure. 11 Recognized limitations of this study include the small cohort of patients and its retrospective nature, thus further clinical experience and recognition of the association of APS to vascular events (arterial and venous) and long-term follow-up are critical for understanding the natural course and establish the appropriate postoperative management and long-term follow-up.…”

“…With respect the conduits, we agree with Lauvao et al in the recommendation of the use of autogenous grafts when possible and a strict perioperative and long-term anticoagulation to prevent graft failure. 11…”

“…8 Antiphospholipid antibody syndrome associated with limb or organ ischemia is rarely encountered and recognized in a vascular surgery practice, and little has been written regarding its therapeutic approach and clinical outcomes. 11 The National Institute of Medical Sciences and Nutrition (INCMNSZ) is a tertiary medical center and research facility in Mexico City that receives and treats a large number of patients with autoimmune diseases and prothrombotic disorders and has one of the largest cohorts of patients with SLE in Latin America. 9,[12][13][14] We identified and studied our institutional experience in patients with primary and secondary APS who underwent surgery due to arterial compromise both thrombotic and thromboembolic with acute, subacute, and chronic clinical manifestations.…”

Nonatherosclerotic Peripheral Artery Disease

“…For example, there have been case reports of large-or medium-vessel vasculitis in patients with rheumatoid arthritis, SLE and ANCA-related vasculitis [30,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62], and uncommon diseases including hypereosinophilic syndrome, Kimura disease, and angiolymphoid hyperplasia with eosinophilia can also mimic Buerger's disease [63][64][65]. Moreover, antiphospholipid syndrome (APS) can occur concomitantly with vasculitis secondary to systemic autoimmune disease (frequently SLE), and can develop into catastrophic APS [66][67][68][69][70][71][72][73] (Figure 10). Certain kinds of vasculitis can be complicated by thrombosis and potentially develop into thrombotic storm which has a devastating clinical course [74][75][76][77].…”

Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases

“…Acute limb ischemia (ALI) and critical limb ischemia (CLI) following ALI are life and limb-threatening diseases that lead to rest-pain, ischaemic ulcers, and gangrene due to impaired perfusion in the lower limbs. A rare potential cause of ALI includes thrombotic artery occlusion associated with hypercoagulable state diseases, such as antiphospholipid syndrome (APS) and essential thrombocythemia (ET) (Suzuki et al 2016 ; Moulinet et al 2016 ; Chong et al 2016 ; Morata Barrado et al 2009 ). Successful revascularisation, including thrombectomy, bypass surgery, endovascular treatment, or hybrid treatment (surgical revascularization and endovascular treatment) for thrombotic artery occlusion in hypercoagulable state patients, has been reported (Moulinet et al 2016 ; Chong et al 2016 ; Morata Barrado et al 2009 ).…”