2018 Volume 27 Issue 5 Pages 417-421
Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by elevation of platelet count and an increased tendency for thrombotic events. We report a case of acute, previously revascularized for chronic occlusion, arterial occlusion of lower extremities associated with ET in whom the legs were salvaged by multiple revascularizations. A 54-year-old man was diagnosed with ET. He first visited our unit at the age of 43 for chronic arterial occlusion of the lower extremities. After controlling platelet count by drug therapy, a right femoro-posterior tibial artery bypass was created using saphenous vein (SV) graft, and a thromboendarterectomy of the deep femoral artery was performed. Three years later, we performed left iliac artery stenting and femoro-popliteal artery bypass using SV graft. After that, he was diagnosed with recurrent acute left lower extremity artery occlusion by thrombosis in peripheral artery and bypass graft. We performed revascularizations, thrombectomy or additional bypass, for a total of five times. Agents to reduce platelet counts, anticoagulants and anti-platelets along with routine monitoring of the blood flow and five prompt additional revascularizations for ischemia in lower extremity have remained the mainstay strategy for limb salvage. The patient is under strict observation. We also reviewed the published cases of chronic arterial occlusion of the lower extremities associated with essential thrombocythemia and have outlined their treatment modalities.
