Superior mesenteric artery embolism associated with Cisplatin-induced aortic thrombosis.

IF 0.5 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING BJR Case Reports Pub Date : 2023-09-12 eCollection Date: 2023-10-01 DOI:10.1259/bjrcr.20220149
Ryo Aoki, Shingo Kato, Kento Nakajima, Jun Sakai, Kenichi Yoshida, Hidenori Masui, Shin Ikeda, Jun Yoshigi, Daisuke Utsunomiya
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Abstract

Cardiovascular complications of cancer therapy are among the most important factors affecting cancer prognosis. Cisplatin-induced aortic thrombosis is rare but can be life-threatening in the event of peripheral embolism. In this report, we describe a case of superior mesenteric artery (SMA) embolism associated with cisplatin-induced aortic thrombosis. A 66-year-old male, diagnosed with esophageal cancer, initiated systemic chemotherapy with a regimen consisting of 5-fluorouracil and cisplatin, combined with radiotherapy. After 7 days of chemoradiotherapy, the patient developed a floating thrombus in the ascending aorta and an SMA embolism; chemoradiotherapy was then discontinued. Laparoscopy revealed an ischemic small intestine that required resection; intravenous unfractionated heparin was initiated 3 days after. Computed tomography showed disappearance of the floating aortic thrombus and reduce SMA thrombus size. Early detection of cisplatin-induced aortic thrombosis may prevent fatal outcomes in symptomatic peripheral embolisms, such as SMA embolism, considering anticoagulation, and discontinuation of cisplatin-based chemotherapy may cause resolution of thrombus events.

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与顺铂诱导的主动脉血栓形成相关的肠系膜上动脉栓塞。
癌症治疗的心血管并发症是影响癌症预后的最重要因素之一。顺铂诱导的主动脉血栓形成是罕见的,但在外周栓塞的情况下可能危及生命。在本报告中,我们描述了一例与顺铂诱导的主动脉血栓形成相关的肠系膜上动脉(SMA)栓塞。一名66岁男性,被诊断为癌症,开始全身化疗,方案包括5-氟尿嘧啶和顺铂,并结合放疗。放化疗7天后,患者出现升主动脉漂浮血栓和SMA栓塞;随后停止放化疗。腹腔镜检查显示小肠缺血,需要切除;3天后开始静脉注射普通肝素。计算机断层扫描显示漂浮的主动脉血栓消失,SMA血栓大小缩小。早期发现顺铂诱导的主动脉血栓形成可以预防有症状的外周栓塞的致命后果,如SMA栓塞,考虑抗凝,停止基于顺铂的化疗可能会导致血栓事件的解决。
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BJR Case Reports
BJR Case Reports RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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发文量
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审稿时长
11 weeks
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