McDaniels Mitchell C, Conroy Patrick D, Batista Philip M
Department of Vascular and Endovascular Surgery, Cooper University Hospital, Camden, NJ.
J Vasc Surg Cases Innov Tech. 2024 Oct 22;11(1):101655. doi: 10.1016/j.jvscit.2024.101655. eCollection 2025 Feb.
This case report presents a 40-year-old transgender female with a history of gender-affirming hormone therapy who experienced recurrent, medication-resistant arterial thrombi leading to bilateral lower extremity amputations. Despite multiple endovascular and surgical interventions, including bypass grafting and catheter-directed thrombolysis, the patient developed recurrent thrombotic events even while on anticoagulation therapy. Hematologic evaluation for coagulopathy was unremarkable. The case underscores the need for greater understanding of gender-affirming hormone therapy's long-term cardiovascular effects while highlighting the challenges in managing arterial thrombosis in transgender patients. Further research is required to guide optimal anticoagulation strategies in this population.
本病例报告介绍了一名40岁的变性女性，她有接受性别确认激素治疗的病史，经历了复发性、药物抵抗性动脉血栓形成，导致双侧下肢截肢。尽管进行了多次血管内和外科干预，包括旁路移植术和导管定向溶栓术，但患者即使在接受抗凝治疗时仍发生复发性血栓事件。针对凝血病的血液学评估无异常。该病例强调了需要更好地了解性别确认激素治疗的长期心血管影响，同时突出了管理变性患者动脉血栓形成的挑战。需要进一步研究以指导该人群的最佳抗凝策略。
