Spontaneous arterial thrombosis in association with pancreatic carcinoma: Diagnosis and interventional management

Abstract

A 58-year-old woman presented with bilateral upper limb ischaemia. Digital subtraction angiography demonstrated upper limb arterial thrombosis, extensive on the left. This was initially treated with catheter-directed thrombolysis which cleared the thrombus on the right, although the left upper limb required supplementary surgical embolectomy. Subsequently, biopsy-proven pancreatic adenocarcinoma was detected. The upper limb arterial thrombosis appeared to be spontaneous in association with the malignancy because there was no obvious embolic source.

Rationale and design of PROSPECT-CONKO 004: a prospective, randomized trial of simultaneous pancreatic cancer treatment with enoxaparin and chemotherapy)

“…Lower-extremity deep venous thrombosis, thrombophlebitis migrans, and pulmonary embolism are among the well-known presentations in pancreatic cancer. Further manifestations also include disseminated intravascular coagulation, splenic vein thrombosis, portal or superior mesenteric vein thrombosis, and spontaneous arterial thromboembolism, extremity ischemia, and mesenteric or iliofemoral occlusion [ 4 - 7 ].…”

Optimal management of venous thromboembolism in advanced pancreatic cancer with low-molecular-weight heparin: current evidence

“…[8][9][10][11] Cancer therapy (surgery, chemotherapy, and hormonal therapy) serves as an additional risk factor for developing VTE. According to a retrospective analysis of the Prophylaxis of Thromboembolism During Chemotherapy (PROTECHT) study, 12 in the absence of thrombophylaxis, the highest risk of thrombosis is seen in patients receiving gemcitabine (8.1%) or cisplatin-based chemotherapy (7%).…”