Ilonczai P, Tóth J, Tóth L, Altorjay I, Boda Z, Palatka K. Catheter-directed thrombolysis in inflammatory bowel diseases: Report of a case. World J Gastroenterol 2012; 18(34): 4791-4793 [PMID: 23002351 DOI: 10.3748/wjg.v18.i34.4791]
Corresponding Author of This Article
Károly Palatka, MD, PhD, Division of Gastroenterology, 2nd Department of Medicine, Medical and Health Science Centre, University of Debrecen, 4032 Debrecen, Hungary. palatka@med.unideb.hu
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Sep 14, 2012; 18(34): 4791-4793 Published online Sep 14, 2012. doi: 10.3748/wjg.v18.i34.4791
Catheter-directed thrombolysis in inflammatory bowel diseases: Report of a case
Péter Ilonczai, Judit Tóth, László Tóth, István Altorjay, Zoltán Boda, Károly Palatka
Péter Ilonczai, Zoltán Boda, Division of Haemostasis, 2nd Department of Medicine, Medical and Health Science Centre, University of Debrecen, 4032 Debrecen, Hungary
Judit Tóth, Euromedic Diagnostics Hungary Ltd., Medical and Health Science Centre, University of Debrecen, 4032 Debrecen, Hungary
László Tóth, Department of Pathology, Medical and Health Science Centre, University of Debrecen, 4032 Debrecen, Hungary
István Altorjay, Károly Palatka, Division of Gastroenterology, 2nd Department of Medicine, Medical and Health Science Centre, University of Debrecen, 4032 Debrecen, Hungary
Author contributions: Ilonczai P collected the data and wrote the article, participated in the treatment of the patient in the intensive care unit; Tóth J carried out the endovascular intervention and made the angiographic pictures; Tóth L analysed the histology; Boda Z supported and supervised the thrombolytic treatment; Altorjay I and Palatka K observed the patient, took care and managed of his IBD and performed the endoscopic investigations, and coordinated the treatment and revised critically the article.
Correspondence to: Károly Palatka, MD, PhD, Division of Gastroenterology, 2nd Department of Medicine, Medical and Health Science Centre, University of Debrecen, 4032 Debrecen, Hungary. palatka@med.unideb.hu
Telephone: +36-52-255152 Fax: +36-52-255152
Received: January 9, 2012 Revised: June 20, 2012 Accepted: June 28, 2012 Published online: September 14, 2012
Abstract
In patients with inflammatory bowel diseases (IBD) the prevalence of thrombosis is 6.2%, the average incidence of thromboembolism (TE) is 3.6 times higher compared to normal population. The TE is a common extraintestinal complication of IBD, squarely associated with the IBD activity. The application of anticoagulant and thrombolytic therapy in severe IBD is an unresolved issue. Herein we report the first case in literature of an active IBD patient with an upper limb acute arterial occlusion and successful catheter-directed thrombolysis (CDT). A 46-year-old male patient is reported who had Crohn’s disease for 10 years. His right hand suddenly became cold and painful. Angiography proved acute occlusion of the brachial and radial artery. Vascular surgery intervention was not applicable. Endoscopy showed extended, severe inflammation of the colon. Despite the severe endoscopic findings, frequent bloody stools and moderate anaemia, CDT with recombinant tissue plasminogen activator was performed. The control angiography proved improvement, the radial artery pulse appeared. No bleeding complication was observed. This case supports that CDT-after careful estimation of the bleeding risk-can be effective and safe in patients with severe or life-threatening TE and active IBD.
