Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2020; 8(24): 6473-6479
Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6473
Recurrent thrombosis in the lower extremities after thrombectomy in a patient with polycythemia vera: A case report
Bu-Ping Jiang, Guo-Bing Cheng, Qiang Hu, Jia-Wen Wu, Xiao-Yang Li, Sheng Liao, Sen-Yan Wu, Wei Lu
Bu-Ping Jiang, Guo-Bing Cheng, Qiang Hu, Jia-Wen Wu, Xiao-Yang Li, Sheng Liao, Sen-Yan Wu, Wei Lu, Department of Vascular Surgery, People’s Hospital of Quzhou, Quzhou 324000, Zhejiang Province, China
Author contributions: Jiang BP contributed drafted the manuscript; Hu Q, Wu JW, and Li XY participated in the patient’s surgeries; Liao S was responsible for the patient’s follow-up; Wu SY reviewed the literature; Cheng GB and Lu W revised the manuscript; All authors issued final approval for this version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest regarding this work.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Lu, BMed, Surgeon, Department of Vascular Surgery, People’s Hospital of Quzhou, No. 2 Zhongloudi, Kecheng District, Quzhou 324000, Zhejiang Province, China. luwei-77@163.com
Received: September 8, 2020
Peer-review started: September 8, 2020
First decision: September 24, 2020
Revised: October 6, 2020
Accepted: November 2, 2020
Article in press: November 2, 2020
Published online: December 26, 2020
Processing time: 102 Days and 2.5 Hours
Abstract
BACKGROUND

Acute arterial embolism of the extremities is a surgical emergency. Atrial fibrillation is the major etiology of acute arterial embolism of the extremities. Emergency femoral artery thrombectomy can successfully treat this issue. However, polycythemia vera (PV) may sometimes explain this medical emergency. Recurrent thrombosis in the lower extremities after thrombectomy can be found in patients with PV, and reoperation is needed for this condition.

CASE SUMMARY

A 68-year-old man in China suffered from sudden pain in the left lower extremity for 14 h. The examination in the emergency department showed a diagnosis of acute arterial embolism of the extremities combined with PV. The patient’s complaint disappeared after repeat emergency thrombectomy.

CONCLUSION

Patients with acute arterial embolism of the extremities should be treated carefully, especially those who have recurrent thrombosis after emergency thrombectomy. Clinicians should be aware of PV, a rare cause of acute arterial embolism of the extremities. The combination of thrombectomy, phlebotomy, and antiplatelet and anticoagulant drugs may be a suitable therapeutic regimen for these patients.

Keywords: Thrombosis; Thrombectomy; Polycythemia vera; Case report

Core Tip: Acute arterial embolism of extremities is a surgical emergency. Atrial fibrillation is the major etiology, and emergency femoral artery thrombectomy is the treatment. However, polycythemia vera (PV) may sometimes explain this medical emergency. Reoperation is needed for recurrent thrombosis after thrombectomy in patients with PV. Here, a patient suffered from sudden pain of left lower extremity for 14 h. Emergency diagnosis was acute arterial embolism of extremities combined with PV. Patient’s complaint disappeared after repeated thrombectomy. Patients with PV having recurrent thrombosis after emergency thrombectomy should be treated carefully. Combination of thrombectomy, phlebotomy, and antiplatelet and anticoagulant drugs may be a suitable therapeutic regimen.