Doganci Suat, Kadan Murat, Kaya Erkan, Erol Gokhan, Gunay Celalettin, Demirkilic Ufuk
Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey.
Cardiovasc J Afr. 2013 Mar 23;24(2):e7-9. doi: 10.5830/CVJA-2012-074.
The pathogenesis of in situ thrombosis in cancer patients is not well known. Possible factors include endothelial damage, decreasing levels of anticoagulant factors and increasing levels of pro-coagulants. In the literature, the incidence of arterial thrombosis in cancer patients is reported to be 3.8%; 5-fluorouracil is mentioned as a rare causative agent, whereas cisplatin is thought to be the most common agent responsible for in situ thrombosis. In this report we present a 43-year-old male patient with bilateral popliteal artery embolism after 5-fluorouracil/cisplatin/taxotare combination chemotheraphy for gastric carcinoma. He had no additional risk factors such as smoking or any persistent organic arterial disease. He had sinus cardiac rhythm on electrocardiography and there were no abnormalities on echocardiography that could have been source of emboli. Surgical thrombectomy was performed with effective anticoagulation. After the operation, our medical oncologist discontinued 5-fluorouracil. At follow up, there was no evidence of thrombosis, with normal vascular flow rate.
癌症患者原位血栓形成的发病机制尚不清楚。可能的因素包括内皮损伤、抗凝因子水平降低和促凝因子水平升高。在文献中，癌症患者动脉血栓形成的发生率据报道为3.8%；5-氟尿嘧啶被提及为一种罕见的致病因素，而顺铂被认为是原位血栓形成的最常见病因。在本报告中，我们介绍了一名43岁男性患者，在接受5-氟尿嘧啶/顺铂/多西他赛联合化疗治疗胃癌后发生双侧腘动脉栓塞。他没有吸烟或任何持续性器质性动脉疾病等其他危险因素。他心电图显示窦性心律，超声心动图未发现可能是栓子来源的异常。在有效抗凝的情况下进行了手术取栓。术后，我们的肿瘤内科医生停用了5-氟尿嘧啶。随访时，没有血栓形成的证据，血管流速正常。
