Departments of Pathology.
Cardiology, and.
Am J Dermatopathol. 2021 Sep 1;43(9):662-666. doi: 10.1097/DAD.0000000000001920.
Different hydrophilic and hydrophobic polymers are used as lubricious coatings to reduce vascular traumas in minimally invasive percutaneous procedures. Although they are usually very safe, there is still a risk of serious complications in patients undergoing such procedures, mostly derived from the devices' coating detachment and systemic embolization. The lungs are the most common organ involved, followed by the central nervous system. Yet, cutaneous embolization is unusual, and only 19 cases are available in the literature. Most commonly, they present as asymptomatic retiform purpura on the lower legs, which tends to involve spontaneously. Correct clinical diagnosis is not suspected in most cases, being cholesterol emboly or vasculitis the preferred options. Time interval since surgical procedure and appearance of lesions vary widely but they generally start in the first few days. Histopathological identification of the embolus as bluish, amorphous intraluminal material in dermal vessels is diagnostic, but vasculitic signs are not present. We report 2 cases of skin lesions as the main manifestation of polymer embolization after endovascular surgical procedures. In both cases, biopsy allowed identification of embolized foreign material and lesions resolved without specific treatment.
不同的亲水和疏水聚合物被用作润滑涂层，以减少微创经皮手术中的血管创伤。虽然它们通常非常安全，但接受此类手术的患者仍有发生严重并发症的风险，这些并发症主要源于器械涂层脱落和全身栓塞。肺部是最常见的受累器官，其次是中枢神经系统。然而，皮肤栓塞并不常见，文献中仅有 19 例报道。最常见的表现为小腿无症状网状紫斑，通常可自发消退。大多数情况下，临床诊断并未怀疑为胆固醇栓塞或血管炎。手术时间间隔和病变表现差异很大，但通常在术后几天内开始出现。血管内手术后皮肤病变的主要表现为聚合物栓塞：组织病理学检查可见蓝色、无定形的腔内物质栓塞在真皮血管中，具有诊断意义，但不存在血管炎的迹象。我们报告了 2 例以皮肤病变为主要表现的聚合物栓塞病例，这两例均通过活检明确了栓塞的异物，且病变未经特殊治疗而缓解。
