Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202200101
Jornal Vascular Brasileiro
Case Report

Tratamento conservador de isquemia aguda de extremidades em lactente - relato de caso

Conservative treatment of acute limb ischemia in a child – case report

Suzanna Maria Viana Sanches; Maurício de Amorim Aquino; Brenda de Lima Leite; Monique Magnavita Borba da Fonseca Cerqueira

Downloads: 2
Views: 478

Resumo

Resumo: A isquemia aguda de extremidades é um evento raro na população pediátrica, com incidência estimada em 26 a cada 100.000 internações, sendo a maioria associada a trauma ou iatrogenia. O tratamento ideal para esses quadros não está bem estabelecido pela literatura, havendo a tendência ao tratamento não invasivo. Relatamos o caso de uma lactente que apresentou isquemia dos quatro membros secundária a complicações hemodinâmicas após realização de cirurgia cardíaca complexa, apresentando preservação tecidual expressiva com o tratamento conservador.

Palavras-chave

isquemia, crianças, anticoagulantes, relato de caso

Abstract

Acute limb ischemia is a rare event in the pediatric population, with an estimated incidence of 26 per 100,000 admissions, the majority of which are associated with trauma or iatrogeny. The ideal treatment for these cases is not well-established in the literature, although there is a tendency to choose noninvasive treatment. We report the case of an infant who suffered ischemia to all four limbs secondary to hemodynamic complications after complex heart surgery and in whom significant tissue preservation was achieved with conservative treatment.

Keywords

ischemia; children; anticoagulants; case report.

References

1 Wang SK, Lemmon GW, Drucker NA, et al. Results of nonoperative management of acute limb ischemia in infants. J Vasc Surg. 2018;67(5):1480-3. http://dx.doi.org/10.1016/j.jvs.2017.09.036. PMid:29224940.

2 Lim S, Javorski MJ, Halandras PM, Kuo PC, Aulivola B, Crisostomo P. Epidemiology, treatment and outcomes of acute limb ischemia in the pediatric population. J Vasc Surg. 2018;68(1):182-8. http://dx.doi.org/10.1016/j.jvs.2017.11.064. PMid:29502995.

3 Kayssi A, Shaikh F, Roche-Nagle G, Brandao LR, Williams SA, Rubin BB. Management of acute limb ischemia in the pediatric population. J Vasc Surg. 2014;60(1):106-10. http://dx.doi.org/10.1016/j.jvs.2014.01.051. PMid:24657296.

4 Durall AL, Phillips JR, Weisse ME, Mullett CJ. Infantile Kawasaki disease and peripheral gangrene. J Pediatr. 2006;149(1):131-3. http://dx.doi.org/10.1016/j.jpeds.2006.02.043. PMid:16860142.

5 von Planta M, Fasnacht M, Holm C, Fanconi S, Seger RA. Atypical Kawasaki disease with peripheral gangrene and myocardial infarction: therapeutic implications. Eur J Pediatr. 1995;154(10):830-4. http://dx.doi.org/10.1007/BF01959792. PMid:8529683.

6 Matos JM, Fajardo A, Dalsing MC, Motaganahalli R, Akingba GA, Murphy MP. Evidence for nonoperative management of acute limb ischemia in infants. J Vasc Surg. 2012;55(4):1156-9. http://dx.doi.org/10.1016/j.jvs.2011.09.092. PMid:22133454.

7 Sadat U, Hayes PD, Varty K. Acute limb ischemia in pediatric population secondary to peripheral vascular cannulation: literature review and recommendations. Vasc Endovascular Surg. 2015;49(5-6):142-7. http://dx.doi.org/10.1177/1538574415604059. PMid:26335994.

8 Arshad A, McCarthy MJ. Management of limb ischaemia in the neonate and infant. Eur J Vasc Endovasc Surg. 2009;38(1):61-5. http://dx.doi.org/10.1016/j.ejvs.2009.03.010. PMid:19362027.

9 Andrew M, David M, DeVeber G, Brooker LA. Arterial thromboembolic complications in paediatric patients. Thromb Haemost. 1997;78(1):715-25. http://dx.doi.org/10.1055/s-0038-1657618. PMid:9198245.

10 Özgenel GY, Akin S, Uysal A, Köksal N, Özcan M. Gangrene of the upper extremity in the newborn. Eur J Plast Surg. 2000;23(8):429-31. http://dx.doi.org/10.1007/s002380000194.
 


Submitted date:
03/22/2022

Accepted date:
09/15/2022

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
6374d951a953951a0c37b4a3 jvb Articles

J Vasc Bras

Share this page
Page Sections