title: Fatal early peripheral post-reperfusion syndrome and the role of cutaneous signs.
abstract: The purpose of this report is to present the case of a 75-year-old male affected by right common femoral artery and abdominal aortic aneurysms. His clinical history was also characterised by post-ischaemic cardiomyopathy, arterial hypertension, chronic respiratory disease and peripheral arterial disease. We performed two surgical procedures: right femoral aneurysmectomy and femoro-femoral bypass and subsequently a femoro-femoral crossover bypass plus right femoro-popliteal bypass below the knee. The second operation became necessary in order to treat acute occlusion of the right iliac-femoral arterial axis. The patient developed a progressive and aggressive lower limb post-perfusion syndrome associated to frank peripheral oedema, myocardial stunning, reperfusion arrhythmias, renal failure and respiratory distress. Cutaneous alterations (oedema of the leg, mottled skin and cyanosis of the foot) were more specific compared with Doppler ultrasound that showed the presence of adequate blood flow in the early phase. On the basis of this experience and of pertinent literature, this study represents a challenge for the understanding of the exact mechanism of origin and progression of post-reperfusion syndrome.
authors.affiliation: Department of Medical and Surgical Science, University Magna Gracia of Catanzaro, Catanzaro, Italy.|Interuniversity Center of Phlebolymphology, International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Gracia of Catanzaro, Catanzaro, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Serra
authors.affiliation: Department of Medical and Surgical Science, University Magna Gracia of Catanzaro, Catanzaro, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Ciranni
authors.affiliation: Department of Medical and Surgical Science, University Magna Gracia of Catanzaro, Catanzaro, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Molinari
authors.affiliation: Department of Experimental and Clinical Medicine, University Magna Gracia of Catanzaro, Catanzaro, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mastroroberto
authors.affiliation: Department of Medical and Surgical Science, University Magna Gracia of Catanzaro, Catanzaro, Italy.|Interuniversity Center of Phlebolymphology, International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Gracia of Catanzaro, Catanzaro, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: de Franciscis
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D000783:Aneurysm / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D003490:Cyanosis / Q000209:etiology*; D004487:Edema / Q000209:etiology*; D017809:Fatal Outcome; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D008297:Male; D017682:Myocardial Stunning / Q000209:etiology; D015424:Reperfusion / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012867:Skin / Q000473:pathology*; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
keywords: Cutaneous alterations; Ischaemia; Oedema; Reperfusion