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High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model
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Bilateral lower extremity gangrene requiring amputation associated with heparin-induced thrombocytopenia--a case

Brian P Dickinson1, Daniel A De Ugarte, Todd D Reil

  • 1University of California Los Angeles Division of Vascular Surgery, Gonda Goldschmied Vascular Center, Los Angeles, CA 90095, USA.

Vascular and Endovascular Surgery
|April 7, 2006
PubMed

Heparin use, both prophylactically and therapeutically, is prevalent among hospitalized patients. Patients on heparin may develop a thrombocytopenia that is self-limited. Fewer patients develop a heparin-induced thrombocytopenia that can cause severe bleeding and thrombosis owing to intravascular platelet aggregation. The authors present a case report of heparin-induced thrombocytopenia in a patient who underwent aortic arch and aortic valve replacement that resulted in bilateral above-knee amputations. The patient developed limb ischemia related to heparin-associated thrombosis, but had a delay in antibody seroconversion. Early and accurate diagnosis of heparin-induced thrombocytopenia requires a high clinical suspicion and may be present despite the absence of serum antibodies.

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