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Bilateral lower extremity amputation in a transgender female on estrogen therapy suffering from recurrent,
Mitchell C McDaniels1, Patrick D Conroy1, Philip M Batista1
1Department of Vascular and Endovascular Surgery, Cooper University Hospital, Camden, NJ.
Abstract:
This case report presents a 40-year-old transgender female with a history of gender-affirming hormone therapy who experienced recurrent, medication-resistant arterial thrombi leading to bilateral lower extremity amputations. Despite multiple endovascular and surgical interventions, including bypass grafting and catheter-directed thrombolysis, the patient developed recurrent thrombotic events even while on anticoagulation therapy. Hematologic evaluation for coagulopathy was unremarkable. The case underscores the need for greater understanding of gender-affirming hormone therapy's long-term cardiovascular effects while highlighting the challenges in managing arterial thrombosis in transgender patients. Further research is required to guide optimal anticoagulation strategies in this population.
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