PMC8219304_01
Patient 1: Left hand, dorsal view, showing ischemia with autolysis of the middle, ring, and little fingers.
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She had the appearance of ischemia due to embolization to the finger tips, and these became gangrenous over the next 4-6 weeks and progressed with some degree of autolysis (Figure 1).
Patient 1: Left upper limb angiogram showing embolization to distal forearm vessels.
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Magnetic resonance (MR) angiography showed no proximal lesions but revealed severe forearm embolization along both radial and ulnar arteries (Figure 2).
PMC8219304_02
Patient 2: Angiogram showing left external iliac artery occlusion.
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An MR angiogram showed a clear filling defect in the left proximal external iliac artery (Figure 3).
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Patient 3: Thrombus load, right axillary artery.
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Because of the recurrent nature of her presentation, she was investigated further with a transthoracic echocardiogram, which showed no intracardiac thrombus, and MR angiography, which demonstrated thrombus at the level of the axillary artery (Figure 4), suggesting that there may have been embolization from this thrombotic lesion.