"Critical Lower Extremity Ischemia and Physical Vascular Therapy, Bemer®"

Abstract

Taking anabolic steroids is associated with many side effects, including hormonal effects, liver damage, blood pressure increase, concentric left ventricular hypertrophy, damage to fat metabolism, immune damage, skin symptoms and arterial thrombosis. In the presented case, the 46-year-old man used anabolic steroids as a cure for 10 years. When he was admitted to the hospital, he complained of pain in his left leg for three days, which was caused by blockage of the left iliac and popliteo-crural arteries. An embolectomy was performed, supplemented with a fasciotomy. Two days later, a CT angiography performed due to an increase in complaints showed a floating thrombus in the left common iliac artery and repeated occlusion of the leg vessels. The CT also showed damage to the liver, right kidney, intestines, and partial thrombosis of the superior mesenteric artery. Repeated lower extremity embolectomy did not yield definitive results. There was an increased chance of possible limb loss. The ischemia of the limb requiring opiate analgesia was compensated with vasodilator infusion treatment, as the source of the central embolism was not confirmed. The fasciotomy wound showed a tendency to heal with regular surgical control. Upon discharge of the patient, after detailed information, we prescribed medications, special nutrients, physical vascular therapy and weekly bandage changes at our specialist ambulance. Thanks to the patient's cooperation, it was possible to achieve complete recovery and return to his previous work. If the surgical thrombectomy is not successful, there is a possibility of limb loss due to critical limb ischemia, prostacyclin treatment is recommended even in the hospital. If the infusion proves to be effective, the limb can be saved by using physical vascular therapy (BEMER®) six times a day at the patient's home. In case of critical limb ischemia, BEMER® proves to be a good choice and is recommended.