Thrombolytic therapy for critical limb ischemia in a Jehovah's Witness with severe anemia.

A patient's refusal to receive blood products can pose both clinical and ethical challenges to the surgeon. In this report, we review the case of a Jehovah's Witness presenting with critical lower limb ischemia and severe anemia for whom the decision of whether to perform thrombolytic therapy was complicated by his refusal to accept blood products. The case demonstrates that thrombolytic therapy can produce favorable results in severely anemic patients even when transfusion is not an option. We conclude that offering thrombolytic therapy in this context is a reasonable therapeutic option from both a clinical and ethical perspective.

Aortic pseudoaneurysm from aortic penetration with a bird's nest vena cava filter.

This is a case report of a 29-year-old woman with an infected aortic pseudoaneurysm. Two years previously a bird's nest vena cava filter was placed after complex gastric surgery. Imaging studies and operative findings showed that the pseudoaneurysm was caused by penetration of the aorta by a prong of the vena cava filter.