MYONEPHROPATHIC METABOLIC SYNDROME AFTER BILATERAL AORTOILIAC BYPASS - A PATHOGENIC ROLE OF CHOLESTEROL MICROEMBOLI - A CASE-REPORT

Citation
H. Fujii et al., MYONEPHROPATHIC METABOLIC SYNDROME AFTER BILATERAL AORTOILIAC BYPASS - A PATHOGENIC ROLE OF CHOLESTEROL MICROEMBOLI - A CASE-REPORT, Vascular surgery, 32(5), 1998, pp. 513-517
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery,"Peripheal Vascular Diseas
Journal title
ISSN journal
0042-2835
Volume
32
Issue
5
Year of publication
1998
Pages
513 - 517
Database
ISI
SICI code
0042-2835(1998)32:5<513:MMSABA>2.0.ZU;2-B
Abstract
A 72-year-old man was admitted to our hospital for management of inter mittent claudication. A preoperative angiogram showed right common ili ac artery occlusion with well-maintained peripheral flow via collatera ls and 50% stenosis of the aortic bifurcation through the left common iliac artery. The authors performed bilateral aortoiliac artery bypass surgery. Immediately following the operation, the left lower limb was cyanotic and cold despite a good pulse in the left dorsalis pedis art ery. He suffered from severe pain throughout his entire left calf and part of his thigh. Thrombolytic therapy combined with anticoagulation therapy was started in an attempt to reduce limb ischemia. However, sw elling of the left calf increased, and clinical and metabolic manifest ations consistent with myonephropathic metabolic syndrome (MNMS) devel oped. Serum creatine kinase and creatinine rose to 21,600 u/L and 2.8 mg/dl, respectively. His toe became necrotic and a transmetatarsal amp utation was done. A skin biopsy taken from the edge of the amputation revealed cholesterol crystals within the capillaries. This report sugg ests that massive cholesterol microemboli are responsible for MNMS in this patient.