Acute Arterial Thrombosis in Leg Associated with Hyperhomocysteinemia.
- Author:
Choon Ho JEONG
1
;
Ki Hyuk PARK
;
Soon Jae JUNG
;
Dong Rak CHOI
;
Dae Hyun JOO
;
Han Il LEE
;
Sung Hwon PARK
;
Yong Woon YU
;
Ki Ho PARK
Author Information
1. Department of Surgery, School of Medicine, Daegu Catholic University, Daegu, Korea. khpark@cu.ac.kr
- Publication Type:Case Report
- Keywords:
Hyperhomocysteinemia;
Acute arterial thrombosis;
Folic acid
- MeSH:
Adult;
Arteries;
Catheters;
Extremities;
Femoral Artery;
Folic Acid;
Follow-Up Studies;
Heart Diseases;
Homocysteine;
Humans;
Hyperhomocysteinemia*;
Leg*;
Male;
Medical Records;
Oxidoreductases;
Plasma;
Recurrence;
Thrombectomy;
Thrombophilia;
Thrombosis*;
Valine
- From:Journal of the Korean Surgical Society
2005;68(1):78-82
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Herein, two cases of acute arterial thrombosis associated with hyperhomocysteinemia are reported. A 34-year old male patient without heart disease, was brought to hospital with an acute ischemic limb due to thromboses of both superficial femoral arteries, where no atherosclerotic lesions were found. Subsequent investigation revealed that the patient had hyperhomocysteinemia, with a low folic acid level. Catheter directed thrombolysis was attempted, but failed, so bypass surgery was performed. After revascularization, anticoagulation therapy and folate supplementation were initiated. His plasma homocysteine level returned to normal, and there has been no recurrence during the 48 month follow up periods. The other case was a 51-year man with an acute left ilio-femoro-popliteal artery occlusion, who had also shown hyperhomocysteinemia, with a low folic acid level. There was nothing abnormal from his medical records, and showed normal findings in his transesophageal echocardiogram. In a serologic hypercoagulability test, everything was normal, with the exception of an increased homocysteine level. After a successful thrombectomy with a Fogarty catheter, folate supplementation was administered until his homocysteine level returned to normal. In both patients, the heterozygous mutation of 5, 10-methylenetetrahydrofolate reductase (MTHFR), C677T (alanine to valine substitution), was detected.
