Abstract
A 47-year-old man with heterozygous factor V Leiden disorder and intermittent hyperhomocysteinemia developed spontaneous acute popliteal artery thrombosis. Homocysteine levels were above normal limits at presentation. Intra-arterial thrombolysis was used successfully to treat the acute thrombosis; long-term treatment included anticoagulation, folic acid, and risk factor modification. Although factor V Leiden is strongly associated with deep venous thrombosis, additional cofactors such as hyperhomocysteinemia may predispose to an increased risk of acute arterial thrombosis in areas of pre-existing peripheral arterial disease.
MeSH terms
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Acute Disease
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Angiography
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Factor V / genetics
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Factor V Deficiency / blood
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Factor V Deficiency / complications*
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Factor V Deficiency / genetics
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Fibrinolytic Agents / administration & dosage
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Fibrinolytic Agents / therapeutic use
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Follow-Up Studies
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Heparin / administration & dosage
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Heparin / therapeutic use
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Heterozygote
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Humans
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Hyperhomocysteinemia / blood
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Hyperhomocysteinemia / complications*
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Injections, Intra-Arterial
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Male
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Middle Aged
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Mutation
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Peripheral Vascular Diseases / complications*
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Popliteal Artery*
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Thromboembolism / diagnostic imaging
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Thromboembolism / drug therapy
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Thromboembolism / etiology*
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Thrombolytic Therapy
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Tissue Plasminogen Activator / administration & dosage
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Tissue Plasminogen Activator / therapeutic use
Substances
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Fibrinolytic Agents
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Factor V
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Heparin
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Tissue Plasminogen Activator