Azize SERCE, Ebru UMAY, Alican KARAKUYU, Aytül ÇAKCI

Buerger hastalığında trombolitik tedaviye bağlı bir komplikasyon: hemorajik inme ve daha fazlası

Buerger Hastalığı (BH), genellikle alt ve üst ekstremitelerdeki küçük ve orta boy damarların tutulduğu non-aterosklerotik inflamatuvar bir hastalık olup sıklıkla genç, sigara içen erkeklerde görülür. Tedavisinde sigarayı bırakmak, medikal ve cerrahi yöntemler kullanılmakla birlikte, özellikle alt ekstremitelerde akut oklüzyonu olan hastalarda trombolitik tedavilerde bir seçenek olmaktadır. Burada medikal tedaviye dirençli BH’na bağlı alt ekstremite trombozu gelişen ve intra-arteriyel trombolitik tedavi verilen, takibinde intrakraniyal kanaması olan, ilacın kesilmesi sonrası da greft oklüzyonuna bağlı sağ diz üstü ampütasyonu yapılmak zorunda kalınan bir vaka sunulmaktadır. Alt ekstremite iskemilerinde uygulanan trombolitik tedavi sonrası en ciddi kanama komplikasyonu intrakraniyal kanama olup %1-2 oranında görülebilir. Bizim olgumuzda intrakraniyal hemoraji gelişimi sonrası, antikoagulan tedavinin kesilmesi, hastanın inmeden etkilenmemiş ekstremitesinin amputasyonu sonucunu doğurmuştur.

A complication through thrombolytic treatment in Buerger's disease: hemorrhagic stroke and more

Buerger's disease is a non-atherosclerotic inflammatory disease that usually involves small and midsized vessels of the lower and upper extremities, and is often seen in young, smoker males. In the treatment of give up smoking, medical and surgical methods are used, especially in patients with acute occlusion of the lower extremities, thrombolytic treatments are an option. Here, we present a case with right knee amputation due to graft occlusion and discontinuation of the drug after the discontinuation of the drug. After thrombolytic therapy in lower extremity ischemia, the most serious bleeding complication is intracranial hemorrhage with a rate of 1-2%. In our case, after the development of intracranial hemorrhage, discontinuation of anticoagulant treatment resulted in amputation of the unaffected extremity of the patient.

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