title: Acute arterial thrombosis following chemotherapy in a patient with a gastric carcinoma.
abstract: The pathogenesis of in situ thrombosis in cancer patients is not well known. Possible factors include endothelial damage, decreasing levels of anticoagulant factors and increasing levels of pro-coagulants. In the literature, the incidence of arterial thrombosis in cancer patients is reported to be 3.8%; 5-fluorouracil is mentioned as a rare causative agent, whereas cisplatin is thought to be the most common agent responsible for in situ thrombosis. In this report we present a 43-year-old male patient with bilateral popliteal artery embolism after 5-fluorouracil/cisplatin/taxotare combination chemotheraphy for gastric carcinoma. He had no additional risk factors such as smoking or any persistent organic arterial disease. He had sinus cardiac rhythm on electrocardiography and there were no abnormalities on echocardiography that could have been source of emboli. Surgical thrombectomy was performed with effective anticoagulation. After the operation, our medical oncologist discontinued 5-fluorouracil. At follow up, there was no evidence of thrombosis, with normal vascular flow rate.
authors.affiliation: Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey. suat_doganci@yahoo.com
authors.forename: Suat
authors.initials: S
authors.lastname: Doganci
authors.forename: Murat
authors.initials: M
authors.lastname: Kadan
authors.forename: Erkan
authors.initials: E
authors.lastname: Kaya
authors.forename: Gokhan
authors.initials: G
authors.lastname: Erol
authors.forename: Celalettin
authors.initials: C
authors.lastname: Gunay
authors.forename: Ufuk
authors.initials: U
authors.lastname: Demirkilic
mesh_terms: D000208:Acute Disease; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001157:Arterial Occlusive Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D002277:Carcinoma / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy*; D043823:Taxoids / Q000008:administration & dosage; D017131:Thrombectomy; D013927:Thrombosis / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
chemical_list: D000925:Anticoagulants; D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil