Femoral Artery Thrombosis in a Very Low Birth Weight Preterm Newborn

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Thromboses are considered to be rare disorders in the pediatric population. However, they occur more frequently during the neonatal period. Potential risk factors for thrombosis onset include frequent use of peripheral, umbilical or central venous / arterial catheters, inflammation, disseminated intravascular coagulation, liver disorders, hypovolemia, asphyxia, congenital heart disease, polycythemia and dehydration. On the seventh day of life in male premature infant born in 29th / 30th gestation week, we noticed an increased level of inflammatory parameters. The patient’s right leg was edematous and cold with immeasurable pulse and pressure over the femoral artery, mottled skin and no spontaneous mobility. In the following days, edema becomes generalized and abdominal meteorism with bile vomiting appeared. Vascular surgeon established a diagnosis of the acute femoral artery stenosis (CW Doppler). We initiated continuous infusion of unfractionated heparin, but due to the development of hemorrhagic syndrome, next day we replaced it with low molecular weight heparin. The hemorrhagic disease was treated with tranexamic acid, fresh frozen plasma and concentrated platelets of the corresponding blood group. Signs of recirculation were registered with a palpable femoral pulse. CW Doppler confirmed complete recovery. In spite of the fact that antithrombotic therapy can cause numerous complications, it should be considered in vital indications.

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