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External iliac artery thrombosis: an unusual complication of femoral venous catheterisation in a neonate
  1. Anvesh Amiti1,
  2. Thangaraj Abiramalatha1,
  3. Makkathai Kanakasabai Ayyappan2 and
  4. Usha Devi Rajendran1
  1. 1Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
  2. 2Vascular Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
  1. Correspondence to Dr Thangaraj Abiramalatha; abi_paeds{at}yahoo.com

Abstract

We report a neonate who developed external iliac artery thrombosis after insertion of femoral venous catheter, without an apparent arterial puncture during the procedure. The baby developed acute limb ischaemia. As there was no improvement despite heparin infusion for 24 hours, thrombectomy was done. Following surgery, the limb perfusion improved gradually in 1 week. However, pulses did not reappear even after antithrombotic therapy for 3 months. There was residual Doppler abnormality in the form of severe narrowing at the origin of superficial femoral artery with reduced flow velocity in superficial femoral, popliteal and tibial arteries. The baby was kept under regular follow-up, with a plan for clinical assessment and Doppler every 6 months and to perform a vascular reconstructive surgery if he develops any clinical feature of chronic limb ischaemia. The baby is now 1 year of age. He is walking normally and there is no limb length discrepancy.

  • neonatal intensive care
  • vascular surgery

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Footnotes

  • Contributors AA conceptualised the case report, performed literature review and drafted the manuscript. TA conceptualised the case report, performed literature review, and critically reviewed and revised the manuscript. She will be the guarantor. MKA and UDR helped in literature search and reviewed the manuscript. All authors read and approved the final version of the manuscript. All authors were involved in the clinical management of the baby.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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