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Lower-limb vasospasm and renal failure during postoperative thromboprophylaxis. Case report
E Mattsson1, A Ohlin, B Balkfors
1Department of Orthopedic Surgery, Malmö General Hospital, Lund University, Sweden.
The European Journal of Surgery = Acta Chirurgica
|April 1, 1991
Summary
Heparin-dihydroergotamine thromboprophylaxis can cause rare limb ischemia and renal failure, particularly after extremity trauma. This case highlights the infrequent but serious risks associated with this medication.
Area of Science:
- Vascular Surgery
- Nephrology
- Pharmacology
Background:
- Thromboprophylaxis is crucial in managing trauma patients to prevent blood clots.
- Heparin-dihydroergotamine is a commonly used anticoagulant for deep vein thrombosis (DVT) prevention.
- Angiospasm is a known but infrequent complication of certain thromboprophylaxis regimens.
Observation:
- A 73-year-old female patient with a trimalleolar fracture developed acute limb ischemia and subsequent renal failure.
- These critical complications arose during treatment with heparin-dihydroergotamine for thromboprophylaxis.
- The patient's presentation suggests a link between the medication and vascular compromise.
Findings:
- The case report reviews previous instances of thromboprophylaxis-induced angiospasm.
- Extremity trauma and shock were identified as significant risk factors for this adverse event.
- Renal failure is noted as a rare but severe outcome in such cases.
Implications:
- This case underscores the importance of vigilant monitoring for vascular complications in patients receiving heparin-dihydroergotamine.
- Awareness of risk factors like trauma is essential for early detection and intervention.
- The findings suggest a need for careful patient selection and consideration of alternative thromboprophylaxis strategies in high-risk individuals.