Rapidly progressing fatal reperfusion syndrome caused by acute critical ischemia of the lower limb

Attila Szijártó, Zsolt Turóczi, József Szabó, Péter Kaliszky, Endre Gyurkovics, Péter Arányi, László Regáli, László Harsányi, G. Lotz

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The most severe complicationof ischemia-reperfusion injury following lower limb arterial surgeryis reperfusion syndrome. Therefore, our aim wastodescribe the extentofmuscle damage and the reperfusion syndrome-related remote organ lesions indetail, through a well-documented case of long-lasting infrarenal aorta thrombosis. After urgent revascularization, several clinical signs of multiple organ dysfunction were detectable, including the circulatory, urinary, respiratory, gastrointestinal, and hemostatic systems. Upon histological examination, intraoperative muscle biopsy showed severe muscle damage. Muscle fiber viability was assessed with a special nitroblue tetrazolium staining-based viability test developed by our team; the obtained results indicated significant degree of muscle damage before this was confirmed by conventional histological methods. Thorough postmortem examination confirmed the presence of remote organ damage. The pathological findings included acute tubular necrosis, myocardial and jejunal infarctions, ischemicpancreatitis, and diffuse alveolar damage with hyaline membrane formation in the lungs and focal centrilobular liver necrosis. By using special staining techniques, the presenceofmyoglobinand lipofuscindeposits was confirmedinthe kidney samples.Inthis paper, we present a patient who developed all major complications following long-lasting arterial occlusion. We also introduceanovel method to assess the degree ofischemic injury, which may besuitableinthe near future for the rapid detection of irreversible muscle injury. Therefore, the mortality of the disease might be reduced.

Original languageEnglish
Pages (from-to)493-500
Number of pages8
JournalCardiovascular Pathology
Volume22
Issue number6
DOIs
Publication statusPublished - Nov 2013

Fingerprint

Reperfusion
Lower Extremity
Ischemia
Muscles
Reperfusion Injury
Necrosis
Staining and Labeling
Nitroblue Tetrazolium
Hyalin
Wounds and Injuries
Hemostatics
Aorta
Autopsy
Thrombosis
Myocardial Infarction
Kidney
Biopsy
Lung
Membranes
Mortality

Keywords

  • Lower limb ischemia
  • Multiorgan failure
  • Reperfusion syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pathology and Forensic Medicine

Cite this

Rapidly progressing fatal reperfusion syndrome caused by acute critical ischemia of the lower limb. / Szijártó, Attila; Turóczi, Zsolt; Szabó, József; Kaliszky, Péter; Gyurkovics, Endre; Arányi, Péter; Regáli, László; Harsányi, László; Lotz, G.

In: Cardiovascular Pathology, Vol. 22, No. 6, 11.2013, p. 493-500.

Research output: Contribution to journalArticle

Szijártó, A, Turóczi, Z, Szabó, J, Kaliszky, P, Gyurkovics, E, Arányi, P, Regáli, L, Harsányi, L & Lotz, G 2013, 'Rapidly progressing fatal reperfusion syndrome caused by acute critical ischemia of the lower limb', Cardiovascular Pathology, vol. 22, no. 6, pp. 493-500. https://doi.org/10.1016/j.carpath.2013.02.006
Szijártó, Attila ; Turóczi, Zsolt ; Szabó, József ; Kaliszky, Péter ; Gyurkovics, Endre ; Arányi, Péter ; Regáli, László ; Harsányi, László ; Lotz, G. / Rapidly progressing fatal reperfusion syndrome caused by acute critical ischemia of the lower limb. In: Cardiovascular Pathology. 2013 ; Vol. 22, No. 6. pp. 493-500.
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