The arterial complications of polycythaemia vera

Abstract

Of 200 patients referred for management of polycythaemia vera, 98 (49 per cent) had presented with vascular complications and 68 (34 per cent) of these involved arteries. Transient but recurrent cerebrovascular accidents and digital artery occlusions were the typical arterial complications. If polycythaemia was not promptly treated there was a risk of perimanent hemiplegia, monocular blindness, and severe ischaemia of the leg. Embolism may have accounted for some of the arterial complications. A possible source for emboli—a proximal mural thrombus—was demonstrated in all 5 patients who were examined with femoral arteriography and in 2 patients who underwent surgery. In selected cases thrombectomy may be indicated to prevent further embolism.