Spontaneous arterial thrombosis in association with pancreatic carcinoma: diagnosis and interventional management

A 58-year-old woman presented with bilateral upper limb ischaemia. Digital subtraction angiography demonstrated upper limb arterial thrombosis, extensive on the left. This was initially treated with catheter-directed thrombolysis which cleared the thrombus on the right, although the left upper limb required supplementary surgical embolectomy. Subsequently, biopsy-proven pancreatic adenocarcinoma was detected. The upper limb arterial thrombosis appeared to be spontaneous in association with the malignancy because there was no obvious embolic source.