Catheter-Directed Thrombolysis for Acute Digit Ischemia in the Setting of Heterozygous Factor V Leiden Mutation: A Case Report and Review of Literature. Issue 4 (23rd October 2022)

• Record Type: Journal Article
• Authors: Nikizad, Hooman; Tsai, David; Lookstein, Robert; Hausman, Michael
• Is Part Of: JBJS case connector. Volume 12:Issue 4(2022)
• Publication Date: 2022-10-23
• Subjects: digit ischemia -- thrombosis -- catheter directed thrombolytics -- thrombolysis -- factor V Leiden -- finger salvage -- digit perfusion -- angiography -- microcatheter; Orthopedic surgery -- Case studies -- Periodicals; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedic surgery; Periodicals; Electronic journals; Case studies; Periodicals; 616.7
• DOI: 10.2106/JBJS.CC.22.00437
• Languages: English
• ISSNs: 2160-3251

Abstract

Abstract : Case: We are reporting the successful treatment of a patient with a heterozygous factor V Leiden mutation who presented with spontaneous thrombotic ischemia of ring and small fingers. Microcatheter-directed administration of thrombolytics at the level of common and proper digital arteries resulted in the salvage of the ring finger to the level of the distal tuft and the entirety of the small finger. Conclusion: Heterozygous factor V Leiden mutation is an extremely unusual etiology for thrombotic digital ischemia. This case report emphasizes the importance of correct diagnosis, timely intervention, and thrombolytic therapy using microcatheters to optimize digital rescue.