Peripheral Arterial Lesions in Patient with Sickle Cell Disease

Vascular occlusion in sickle cell disease (SCD) is often considered to be synonymous with occlusion of microvasculature by sickled red blood cells. However, other mechanisms are also involved. One of these is intimal hyperplasia in the macrovasculature. This creates irregular areas of endoluminal narrowing, which may promote thrombogenic occlusion. This process has not been documented in the peripheral arteries. We report a 14 year-old boy with SCD who developed critical ischemia right foot with absence of atherosclerotic risk factors. Assessment of the patient revealed wide spread arterial disease in both upper and lower extremities.