# Acute arterial occlusion following inadvertent infusion of ferric hydroxide sacarate (Noripurum®) into the radial artery: case report

## TL;DR

A case report describes severe arterial blockage after accidental injection of a iron compound into an artery, highlighting risks of iron overload on blood vessels.

## Contribution

This case report provides new clinical insights into the vascular risks of parenteral iron administration and endothelial injury.

## Key findings

- Inadvertent intra-arterial infusion of ferric hydroxide saccharate caused severe acute arterial occlusion.
- The outcome remained unfavorable despite surgical and pharmacological interventions.
- The case highlights poorly understood interactions between iron overload and endothelial dysfunction.

## Abstract

Iron overload, whether acute or chronic, has been implicated in the pathogenesis of ischemic cardiovascular diseases. However, its effects on peripheral vascular function and thrombotic responses to endothelial injury remain incompletely elucidated. We present a case of inadvertent intra-arterial infusion of ferric hydroxide saccharate (Noripurum®), resulting in severe acute arterial occlusion, most likely secondary to diffuse endothelial injury. Despite prompt surgical intervention and adjunctive pharmacological therapy, the clinical outcome was unfavorable. Given the lack of similar reports in major scientific databases and the involvement of complex, yet poorly characterized, interactions between iron overload and endothelial dysfunction, this case contributes valuable insights into the vascular implications of parenteral iron administration.

A sobrecarga de ferro, seja aguda ou crônica, tem sido associada a eventos adversos na patogênese de doenças cardiovasculares isquêmicas. No entanto, os efeitos do excesso de ferro na função vascular periférica e na resposta trombótica à lesão endotelial ainda não são bem compreendidos. Reportamos um caso de infusão arterial inadvertida de sacarato de hidróxido férrico (Noripurum®), que ocasionou um quadro de oclusão arterial aguda severa por provável lesão endotelial difusa e que, mesmo após tratamento cirúrgico e terapia medicamentosa, não evoluiu satisfatoriamente. Como não encontramos relatos semelhantes na literatura nas principais bases de dados disponíveis e por envolver reações complexas ainda não compreendidas entre sobrecarga de ferro e lesão endotelial dos vasos, optamos por fazer este relato.