Sabzevari Nina, Schapiro Brian L, Stewart Brian
Dermatology Residency, St. Joseph Mercy Hospital, Ann Arbor, Mich.
Faculty, Department of Pathology/Dermatopathology, IHA/St. Joseph Mercy Hospital, Ann Arbor, Mich.
J Vasc Surg Cases Innov Tech. 2019 Jun 29;5(3):310-313. doi: 10.1016/j.jvscit.2019.03.004. eCollection 2019 Sep.
A 63-year-old man presented with left lower extremity ischemia and pain. Left lower extremity angiography revealed calcification throughout the superficial femoral artery, prompting atherectomy and angioplasty with a drug-coated balloon. About 1 week after the procedure, he developed angulated ulcers with central eschar on the left lower extremity and was referred to the dermatology clinic. A biopsy showed cutaneous intravascular foreign material consistent with hydrophilic polymer gel. In patients who develop retiform purpura and ulcerations after endovascular procedures, the diagnosis of hydrophilic polymer embolus should be considered. Treatment consists of supportive care, making early identification vital to avoid unnecessary amputation.
一名63岁男性因左下肢缺血和疼痛就诊。左下肢血管造影显示股浅动脉全程钙化，遂行斑块旋切术及药物涂层球囊血管成形术。术后约1周，他左下肢出现有角的溃疡，中央有焦痂，被转诊至皮肤科诊所。活检显示皮肤血管内有与亲水性聚合物凝胶相符的异物。对于血管内介入术后出现网状紫癜和溃疡的患者，应考虑亲水性聚合物栓子的诊断。治疗包括支持治疗，早期识别对于避免不必要的截肢至关重要。
