Öz
Buerger's disease is a non-atherosclerotic inflammatory disease that usually involves small and mid-sized vessels of the lower and upper extremities, and is often seen in young, smoker males. In the treatment of give up smoking, medical and surgical methods are used, especially in patients with acute occlusion of the lower extremities, thrombolytic treatments are an option. Here, we present a case with right knee amputation due to graft occlusion and discontinuation of the drug after the discontinuation of the drug. After thrombolytic therapy in lower extremity ischemia, the most serious bleeding complication is intracranial hemorrhage with a rate of 1-2%. In our case, after the development of intracranial hemorrhage, discontinuation of anticoagulant treatment resulted in amputation of the unaffected extremity of the patient.
Anahtar Kelimeler
Kaynakça
- Arkkila PE. Thromboangiitis obliterans (Buerger's disease). Orphanet journal of rare diseases. 2006; 1: 14.
- Wen-Wei Huang C-HW, Chien-Feng Li, Ming-Chyi Pai. Late Onset Buerger's Disease with Multiple Cerebral Infarcts. Tzu Chi Med J. 2007; 19: 28-31.
- Malecki R, Kluz J, Przezdziecka-Dolyk J, Adamiec R. The Pathogenesis and Diagnosis of Thromboangiitis obliterans: Is It Still a Mystery? Advances in clinical and experimental medicine : official organ Wroclaw Medical University. 2015; 24 (6): 1085-97.
- Giannini D, Balbarini A. Thrombolytic therapy in peripheral arterial disease. Current drug targets Cardiovascular & haematological disorders. 2004; 4 (3): 249-58.
- Biller J, Asconape J, Challa VR, Toole JF, McLean WT. A case for cerebral thromboangiitis obliterans. Stroke. 1981; 12 (5): 686-9.
- Olin JW, Young JR, Graor RA, Ruschhaupt WF, Bartholomew JR. The changing clinical spectrum of thromboangiitis obliterans (Buerger's disease). Circulation. 1990; 82 (5 Suppl): IV3-8.
- Koraen L, Kuoppala M, Acosta S, Wahlgren CM. Thrombolysis for lower extremity bypass graft occlusion. Journal of vascular surgery. 2011; 54 (5): 1339-44.
- Clagett GP, Sobel M, Jackson MR, Lip GY, Tangelder M, Verhaeghe R. Antithrombotic therapy in peripheral arterial occlusive disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004; 126 (3 Suppl): 609-26.
- Cacione DG, Macedo CR, Baptista-Silva JC. Pharmacological treatment for Buerger's disease. The Cochrane database of systematic reviews. 2016; 3: CD011033.
- Klein-Weigel P, Volz TS, Zange L, Richter J. Buerger's disease: providing integrated care. Journal of multidisciplinary healthcare. 2016; 9: 511-8.
Öz
Buerger Hastalığı (BH), genellikle alt ve üst ekstremitelerdeki küçük ve orta boy damarların tutulduğu non-aterosklerotik inflamatuvar bir hastalık olup sıklıkla genç, sigara içen erkeklerde görülür. Tedavisinde sigarayı bırakmak, medikal ve cerrahi yöntemler kullanılmakla birlikte, özellikle alt ekstremitelerde akut oklüzyonu olan hastalarda trombolitik tedavilerde bir seçenek olmaktadır. Burada medikal tedaviye dirençli BH’na bağlı alt ekstremite trombozu gelişen ve intra-arteriyel trombolitik tedavi verilen, takibinde intrakraniyal kanaması olan, ilacın kesilmesi sonrası da greft oklüzyonuna bağlı sağ diz üstü ampütasyonu yapılmak zorunda kalınan bir vaka sunulmaktadır. Alt ekstremite iskemilerinde uygulanan trombolitik tedavi sonrası en ciddi kanama komplikasyonu intrakraniyal kanama olup %1-2 oranında görülebilir. Bizim olgumuzda intrakraniyal hemoraji gelişimi sonrası, antikoagulan tedavinin kesilmesi, hastanın inmeden etkilenmemiş ekstremitesinin amputasyonu sonucunu doğurmuştur.
Anahtar Kelimeler
Kaynakça
- Arkkila PE. Thromboangiitis obliterans (Buerger's disease). Orphanet journal of rare diseases. 2006; 1: 14.
- Wen-Wei Huang C-HW, Chien-Feng Li, Ming-Chyi Pai. Late Onset Buerger's Disease with Multiple Cerebral Infarcts. Tzu Chi Med J. 2007; 19: 28-31.
- Malecki R, Kluz J, Przezdziecka-Dolyk J, Adamiec R. The Pathogenesis and Diagnosis of Thromboangiitis obliterans: Is It Still a Mystery? Advances in clinical and experimental medicine : official organ Wroclaw Medical University. 2015; 24 (6): 1085-97.
- Giannini D, Balbarini A. Thrombolytic therapy in peripheral arterial disease. Current drug targets Cardiovascular & haematological disorders. 2004; 4 (3): 249-58.
- Biller J, Asconape J, Challa VR, Toole JF, McLean WT. A case for cerebral thromboangiitis obliterans. Stroke. 1981; 12 (5): 686-9.
- Olin JW, Young JR, Graor RA, Ruschhaupt WF, Bartholomew JR. The changing clinical spectrum of thromboangiitis obliterans (Buerger's disease). Circulation. 1990; 82 (5 Suppl): IV3-8.
- Koraen L, Kuoppala M, Acosta S, Wahlgren CM. Thrombolysis for lower extremity bypass graft occlusion. Journal of vascular surgery. 2011; 54 (5): 1339-44.
- Clagett GP, Sobel M, Jackson MR, Lip GY, Tangelder M, Verhaeghe R. Antithrombotic therapy in peripheral arterial occlusive disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004; 126 (3 Suppl): 609-26.
- Cacione DG, Macedo CR, Baptista-Silva JC. Pharmacological treatment for Buerger's disease. The Cochrane database of systematic reviews. 2016; 3: CD011033.
- Klein-Weigel P, Volz TS, Zange L, Richter J. Buerger's disease: providing integrated care. Journal of multidisciplinary healthcare. 2016; 9: 511-8.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 13 Mart 2020 |
| Gönderilme Tarihi | 27 Aralık 2018 |
| Yayımlandığı Sayı | Yıl 2020Cilt: 59 Sayı: 1 |
