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Recurrent Acute Limb Ischemia and Successful Treatment with Endovascular Thrombectomy

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초록

Atrial fibrillation (AF) is associated with an increased risk of thromboembolic events; however, many patients with AF are noncompliant with medication regimens, which increases said risk substantially. Suboptimal health literacy presents significant hurdles to compliance with medical treatment. Here we present a case of an elderly Hispanic woman with AF and several comorbidities, including a history of dementia, who presented with consecutive recurrence of acute limb ischemia in the bilateral lower extremities just 3 days apart. Both events were successfully treated with endovascular thrombectomy. This case study not only showcases the efficacy of the latest endovascular technologies, but also draws attention to the importance of strict patient medication adherence in AF and the effects that health literacy can have on said adherence.

Abstract

Atrial fibrillation (AF) is associated with an increased risk of thromboembolic events; however, many patients with AF are noncompliant with medication regimens, which increases said risk substantially. Suboptimal health literacy presents significant hurdles to compliance with medical treatment. Here we present a case of an elderly Hispanic woman with AF and several comorbidities, including a history of dementia, who presented with consecutive recurrence of acute limb ischemia in the bilateral lower extremities just 3 days apart. Both events were successfully treated with endovascular thrombectomy. This case study not only showcases the efficacy of the latest endovascular technologies, but also draws attention to the importance of strict patient medication adherence in AF and the effects that health literacy can have on said adherence.

참고문헌 (10)

  1. Violi F, "Mechanisms and management of thrombo-embolism in atrial fibrillation", J Atr Fibrillation, 7, pp.1112~ (2014)
  2. Quinn FR, "Screening for undiagnosed atrial fibrillation in the community", Curr Opin Cardiol, 29, pp.28~35 (2014)
  3. Joung B, "2018Korean guideline of atrial fibrillation management", Korean Circ J, 48, pp.1033~1080 (2018)
  4. Frost L, "Incident thromboembolism in the aorta and the renal, mesenteric, pelvic, and extremity arteries after discharge from the hospital with a diagnosis of atrial fibrillation", Arch Intern Med, 161, pp.272~276 (2001)
  5. Lin YS, "Thromboembolic events in atrial fibrillation : different level of risk and pattern between peripheral artery disease and coronary artery disease", Arch Cardiovasc Dis, 114, pp.176~186 (2021)
  6. Ptaszynska-Kopczynska K, "Atrial fibrillation in patients with acute pulmonary embolism : clinical significance and impact on prognosis", Biomed Res Int, 2019, pp.7846291~ (2019)
  7. El-Saifi N, "Medication adherence in older patients with dementia : a systematic literature review", J Pharm Pract, 31, pp.322~334 (2018)
  8. White ND, "Medication nonadherence in the Latino population, language barriers and considerations", Am J Lifestyle Med, 9, pp.43~45 (2015)
  9. Yi J, "Debating multicultural Korea : media discourse on migrants and minorities in South Korea", J Ethn Migr Stud, 41, pp.985~1013 (2015)
  10. Majmundar M, "Comparison of 6-month outcomes of endovascular vs surgical revascularization for patients with critical limb ischemia", JAMA Netw Open, 5, pp.e2227746~ (2022)

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