Journal article
Ischemic Toe Ulceration Due to Foreign Body Embolus From Hydrophilic Polymer-Coated Intravascular Device
Vascular and endovascular surgery, Vol.53(7), pp.606-608
10/01/2019
DOI: 10.1177/1538574419861771
PMID: 31272303
Abstract
Hydrophilic polymer coatings are now widely applied to catheters and other intravascular devices used in neurovascular, cardiovascular, and peripheral vascular procedures. Emboli consisting of these materials have been previously identified in biopsies and autopsies following pulmonary infarction, stroke, gangrene, or death. We report a case involving a nonhealing foot ulcer that appeared following cardiac catheterization, stenting, and automatic implanted cardiac defibrillator (AICD) implantation in a patient without other evidence of significant peripheral artery disease. An 85-year-old woman with chronic atrial fibrillation, aortic valve stenosis, and coronary artery disease underwent coronary stenting and AICD implantation for ventricular tachycardia and syncope. She developed a toe ulcer shortly thereafter, which did not respond to standard treatment. A histological examination following amputation of the toe found amorphous basophilic material in capillaries adjacent to the edge of the ulcer, which was similar to material associated with hydrophilic polymer coatings. Ischemia and infarcts following endovascular procedures should not be presumed to result from thrombus or vascular disease, even if intravascular devices appear intact or properly placed after the procedure. To help establish the incidence of ischemia caused by hydrophilic polymer device coatings, if excision of ischemic or infarcted tissue after endovascular procedures using coated devices becomes necessary, the tissue should be evaluated microscopically. Surgeons should also consider the tolerance of distal organs to infarct or ischemia when selecting coated intravascular devices.
Details
- Title: Subtitle
- Ischemic Toe Ulceration Due to Foreign Body Embolus From Hydrophilic Polymer-Coated Intravascular Device
- Creators
- Bryce French - Swedish Medical CenterRostislav Ranguelov - Swedish Medical CenterKaj Johansen - Swedish Medical CenterSwee Lian Tan - Swedish Medical Center
- Resource Type
- Journal article
- Publication Details
- Vascular and endovascular surgery, Vol.53(7), pp.606-608
- Publisher
- Sage
- DOI
- 10.1177/1538574419861771
- PMID
- 31272303
- ISSN
- 1538-5744
- eISSN
- 1938-9116
- Number of pages
- 3
- Language
- English
- Date published
- 10/01/2019
- Academic Unit
- Pathology
- Record Identifier
- 9984294924202771
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