Lower limb arterial thrombosis due to biopolymer injection: A case report

Milly J. Vecino-Moreno , Álvaro J. Vivas , Gabriel J. Tobón , David Aguirre-Valencia
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Abstract

Introduction

Demand of biopolymer injections has steadily increased in the last decade. Complications associated with this procedure can be innocuous or even life-threatening, presenting from immediately to years later, locally or systemically, with mechanical, inflammatory, or autoimmune characteristics.

Objectives

To present a rare manifestation of an increasing health problem, clinicians must be attentive to this kind of complication.

Materials and methods

Clinical and laboratory data were searched from the clinical history; informed consent was obtained, and the Ethics Committee of Fundación Valle del Lili reviewed and approved this study. We report a patient who presented long-standing symptoms but only consulted after the onset of an acute lower limb arterial thrombosis that could have been fatal without rapid intervention. Ischemia was secondary to arterial obstruction related to biopolymer migration.

Results

A femoral and popliteal embolectomy was performed in which severe soft tissue fibrosis and encapsulated bodies were observed. The patient received thromboprophylaxis and low-dose oral glucocorticoid presenting a favorable evolution.

Conclusions

This substance probably acted as a foreign body and triggered an inflammatory reaction with a subsequent state of hypercoagulability, fibrosis, and nodule formation.

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生物聚合物注射导致的下肢动脉血栓:病例报告
导言在过去十年中,生物聚合物注射的需求稳步增长。与这种手术相关的并发症可能是无害的,也可能是危及生命的,可在局部或全身立即出现,也可在数年后出现,具有机械性、炎症性或自身免疫性特征。材料和方法从临床病史中查找临床和实验室数据;获得知情同意,并由 Valle del Lili 基金会伦理委员会审查和批准了本研究。我们报告了一名长期存在症状的患者,该患者在急性下肢动脉血栓形成后才就诊,如不迅速干预可能会致命。缺血是继发于与生物聚合物迁移有关的动脉阻塞的结果进行了股动脉和腘动脉栓子切除术,术中观察到严重的软组织纤维化和包裹体。患者接受了血栓预防治疗和小剂量口服糖皮质激素,病情发展良好。结论这种物质可能是异物,引发了炎症反应,随后出现高凝状态、纤维化和结节形成。
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