Vascular occlusion in sickle cell disease (SCD) is often considered to be synonymous with occlusion of microvasculature by sickled red blood cells. However, other mechanisms are also involved. One of these is intimal hyperplasia in the macrovasculature. This creates irregular areas of endoluminal narrowing, which may promote thrombogenic occlusion. This process has not been documented in the peripheral arteries. We report a 14 year-old boy with SCD who developed critical ischemia right foot with absence of atherosclerotic risk factors. Assessment of the patient revealed wide spread arterial disease in both upper and lower extremities.
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Published online: July 09, 2007
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- Peripheral Arterial Lesions in Patient with Sickle Cell DiseaseEJVES ExtraVol. 14Issue 2
- PreviewVascular occlusion in sickle cell disease (SCD) is often considered to be synonymous with occlusion of microvasculature by sickled red blood cells. However, other mechanisms are also involved. One of these is intimal hyperplasia in the macrovasculature. This creates irregular areas of endoluminal narrowing, which may promote thrombogenic occlusion. This process has not been documented in the peripheral arteries. We report a 14 year-old boy with SCD who developed critical ischemia right foot with absence of atherosclerotic risk factors.
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- Invited Commentary on “Fast Track Open Aortic Surgery: Reduced Postoperative Stay with a Goal Directed Pathway”. Towards Aneurysm Repair in Day-care?European Journal of Vascular and Endovascular SurgeryVol. 34Issue 3
- PreviewIn their paper on fast track open aortic surgery Murphy et al. have demonstrated, that a simple re-evaluation of standard clinical care may result in significant improvement. By introducing a goal directed clinical pathway for elective open aortic aneurysm repair in unselected patients without any modification in technique or incorporation of new treatment modalities they were able to reduce postoperative hospital stay from 9 to 5 days. The pathway mainly aimed at avoidance of unnecessary or prolonged interventions by promoting early removal of ‘tubes’, early feeding and prompt mobilisation, resembling the multimodal approach in open colonic surgery.
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