AI Article Synopsis
- Cancer patients face a higher risk of venous thromboembolic events, and some chemotherapy drugs have been linked to these complications, although acute arterial ischemia is less commonly reported.
- In a study over 10 years at a university hospital, 16 out of 419 patients who underwent surgery for acute limb ischemia were found to have cancer, with common cases involving urogenital and lung cancers.
- The majority of these patients received surgical intervention, but there was a notable rate of limb loss and in-patient mortality, pointing to the importance of early diagnosis and treatment in improving survival chances.
Article Abstract
Background: Cancer patients have an increased risk of venous thromboembolic events. Certain chemotherapeutic agents have also been associated with the development of thrombosis. Reported cases of acute arterial ischemic episodes in cancer patients are rare.
Methods: Patients who underwent surgery for acute limb ischemia associated with malignancy in a university teaching hospital over a 10-year period were identified. Patient demographics, cancer type, chemotherapy use, site of thromboembolism, treatment and outcome were recorded.
Results: Four hundred nineteen patients underwent surgical intervention for acute arterial ischemia, 16 of these patients (3.8%) had associated cancer. Commonest cancer sites were the urogenital tract (n = 5) and the lungs (n = 5). Eight patients (50%) had been recently diagnosed with cancer, and four (25%) of these cancers were incidental findings after presentation with acute limb ischemia. Four patients (25%) developed acute ischemia during chemotherapy. The superficial femoral artery was the most frequent site of occlusion (50%), followed by the brachial (18%) and popliteal (12%) arteries. All patients underwent thromboembolectomy, but two (12%) patients subsequently required a bypass procedure. Six patients (37%) had limb loss, and in-patient mortality was 12%. Histology revealed that all occlusions were due to thromboembolism, with no tumor cells identified. At follow-up, 44% of patients were found to be alive after 1 year.
Conclusion: Cancer and chemotherapy can predispose patients to acute arterial ischemia. Unlike other reports that view this finding as a preterminal event most appropriately treated by palliative measures, in this series, early diagnosis and surgical intervention enabled limb salvage and patient survival.
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| http://dx.doi.org/10.1016/j.avsg.2011.06.002 | DOI Listing |
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