Common and external iliac artery occlusion in Behçet’s disease: a case of anchoring bias

Abstract

This report describes the case of a 45-year-old woman with a history of Behçet’s disease and complex regional pain syndrome of her legs who presented with severe pain and swelling in her left lower extremity. The patient was initially diagnosed with exacerbation of complex regional pain syndrome, which fit the symptom complex of hyperalgesia, oedema and skin temperature changes. However, after unsuccessful attempts at significant pain relief during admission, CT angiography demonstrated occlusion of the left common and external iliac arteries, a limb-threatening emergency. This case describes an example of anchoring bias, a type of cognitive bias in which there is a tendency to rely too heavily on an initial piece of information, the ‘anchor’, when making decisions. This report emphasises that clinicians should be aware of biases when making decisions and avoid anchoring bias by asking themselves if their diagnosis is influenced by any leading pieces of information.

Oxidative Stress and Inflammation Markers Associated with Multiple Peripheral Artery Occlusions in Elderly Patients

“…In this research, we evaluated the relationships among oxidative stress, pro-inflammatory MIME/NF-κB/P53/TLR4 signaling pathway, and multiple peripheral artery occlusions in older patients. Studies show that peripheral artery occlusion occurs at an advanced stage of atherosclerosis and peripheral artery occlusion is defined as atherosclerotic occlusions of the lower limb arteries (chronic total occlusions of iliac, popliteal, and femoral arteries) 14,[66][67][68][69][70] presented with asymptomatic chronic total occlusions of lower limb arteries (the elderly patients with peripheral artery occlusions are often asymptomatic) 14,[66][67][68][69][70] and different clinical symptoms, including limb intermittent claudication, ischemic lower extremity pain, chronic ischemic rest pain, absence of lower limb arterial pulse, lower abdominal pain and lower limb swelling, or ischemic ulcers and gangrene in the lower extremities. 14,[66][67][68][69][70][71] Advanced atherosclerosis is further defined as artery chronic total occlusions with no antegrade artery blood flow that is present for >3 months and chronic total occlusive lesions are characterized by necrotic cores in atherosclerotic plaques, bifurcation occlusions, longer occlusive lesions, occlusions with calcification, and adverse arterial remodeling.…”