RT Journal Article
SR Electronic
T1 Steal phenomenon in the lower limb: presentation of a case with osseous metastases secondary to renal cell carcinoma and review of the literature
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr0820080609
DO 10.1136/bcr.08.2008.0609
VO 2009
A1 Mohammed Asha
A1 Husam Ibrahim
A1 Abdalla Khidir Eisawi
A1 Richard Orme
A1 Andrew Houghton
YR 2009
UL http://casereports.bmj.com/content/2009/bcr.08.2008.0609.abstract
AB Renal cell carcinoma is reported to have potent angiogenic activity with a high microvascular density in both primary and metastatic sites compared with other adenocarcinomas. Angiogenesis can lead to the formation of abnormal arteriovenous shunts that can, in patients with peripheral vascular disease, result in worsening of the degree of ischaemia by producing a vascular steal-like phenomena. Nevertheless, steal phenomena secondary to malignancies are extremely rare. We report a case of distal critical limb ischaemia in a patient with peripheral vascular disease exacerbated by massive arteriovenous shunting due to tibial metastases from renal cell carcinoma.