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Necrotic leg ulcers secondary to hydrophilic polymer gel emboli

Nina Sabzevari1, Brian L Schapiro2, Brian Stewart3

  • 1Dermatology Residency, St. Joseph Mercy Hospital, Ann Arbor, Mich.

Journal of Vascular Surgery Cases and Innovative Techniques
|July 24, 2019
PubMed

Insights

Hydrophilic polymer emboli can cause skin ulcers after endovascular procedures. Early identification of this rare complication is crucial to prevent limb loss.

Area of Science:

  • Vascular Surgery
  • Dermatology
  • Pathology

Background:

  • Peripheral artery disease management often involves endovascular procedures like atherectomy and angioplasty.
  • Superficial femoral artery calcification can complicate these interventions.

Observation:

  • A 63-year-old male developed painful, angulated ulcers with eschar on his left lower extremity one week post-procedure.
  • Biopsy revealed intravascular foreign material consistent with hydrophilic polymer gel.

Findings:

  • The patient's symptoms were attributed to hydrophilic polymer emboli, a rare complication of endovascular procedures.
  • Retiform purpura and ulcerations following such interventions warrant consideration of this diagnosis.

Implications:

  • Early diagnosis of hydrophilic polymer emboli is vital for appropriate management.
  • Prompt identification can prevent misdiagnosis and potentially avoid unnecessary amputation through supportive care.

Keywords:
AngioplastyEmboliHydrophilic polymer gelPurpuraRevascularizationUlcers

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