Lower Limb Ischemia: Aortoiliac Thrombosis Related to Antiphospholipid Syndrome (APS)—Case Report and Review of the Literature

Abstract

Antiphospholipid syndrome (APS) is recognized as one of the main determinants of hypercoagulable conditions. The literature reports the incidence of this syndrome in a third of patients who underwent surgery for peripheral revascularization. Antiphospholipid antibodies are divided into two categories in relation to specific diagnostic tests. The first group is called lupus anticoagulant and consists of immunoglobulins that inhibit the phospholipid dependent coagulation tests in vitro. The second group is defined by their ability to conduct the phospholipid in an ELISA test. The occurrence of thrombotic events in patients with systemic erythematosus lupus (SEL) and anticoagulant antibodies was described for the first time in 1963 by Bowie. The discovery of anti-cardiolipin antibodies in antiphospholipid syndrome is due to Harris et al. who described the syndrome. Primitive APS was consequently defined in the absence of further underlying illnesses. In this disease, arterial thrombosis occurs mainly in the brain. Peripheral arteries are affected less frequently. Thrombosis of the great vessels is reported as anecdotal.

Successful Endovascular Treatment for Aortic Thrombosis Due to Primary Antiphospholipid Syndrome: A Case Report and Literature Review

“…To the best of our knowledge, only 14 cases have been reported in the literature (Table 1). [5][6][7][8][9][10][11][12][13][14][15][16][17] Among the 11 cases in which details were described, the most common lesion site was the infrarenal aorta. Regarding the treatment strategy, surgical options, including bypass-grafting or endarterectomy, were performed in 7 cases and thrombolysis in 2.…”

Trombosis primaria de la descendente anterior en un paciente con síndrome de anticuerpos antifosfolípidos

“…La enfermedad arterial periférica también ha sido descrita en el SAF y puede tener diversas presentaciones 11,12 . En este caso se decidió diferir el tratamiento de esta alteración hasta que el paciente se recuperara del evento coronario.…”

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

“…6 Antiphospholipid antibody syndrome can be primary in the absence of any other related disease (autoimmune or connective tissue disorders), or secondary in the presence of autoimmune diseases such as SLE. 7 The deep veins of the lower limbs are the most commonly affected sites 8,9 ; on the other hand, the incidence of primary arterial involvement is unknown because no literature has differentiated between thromboembolic disease from the presence of underlying atherosclerotic disease in this particular group of patients. 10 According to the literature reports, the most affected arteries are the coronary circulation followed by the visceral vessel district, renal, retinal, and peripheral arteries, 2 and according to Toffon et al, there are only 5 cases of aortic thrombosis reported in patients with APS.…”