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08:16
High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model
Published on: March 16, 2022
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Acute leukemia presenting as acute lower limb ischemia.
Alkis Bontinis1, Vangelis Bontinis1, Andreas Koutsoumpelis1
1Department of Vascular Surgery, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, Greece.
VASA. Zeitschrift Fur Gefasskrankheiten
|November 19, 2021
Summary
Acute lower limb ischemia (ALLI) as an initial symptom of acute leukemia (AL) is rare but serious. Early diagnosis is vital for survival and limb salvage in these high-risk patients.
Area of Science:
- Vascular Surgery
- Hematology
- Oncology
Background:
- Acute lower limb ischemia (ALLI) is a vascular emergency.
- ALLI as the initial presentation of acute leukemia (AL) is uncommon.
- This review examines ALLI in the context of AL, focusing on management and outcomes.
Observation:
- A systematic review included 26 patients diagnosed with ALLI as the first sign of AL.
- The diagnoses comprised acute myeloid leukemia (AML), acute promyelotic leukemia (APL), and acute lymphoblastic leukemia (ALL).
- Treatments included chemotherapy, thrombectomy, or a combination, with significant rates of major amputation and 30-day mortality.
Findings:
- ALLI as an initial symptom of AL is associated with high mortality (35.7%) and amputation rates (30.8%).
- Acute promyelotic leukemia (APL) represented a notable proportion of cases.
- Recurrent thrombotic events were common, affecting 12 patients.
Implications:
- Timely diagnosis of ALLI in AL is critical for improving short-term survival and limb salvage.
- Further research into the role of leukostasis and the efficacy of leukapheresis is warranted.
- This rare presentation highlights the need for a multidisciplinary approach in managing these complex cases.
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