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A 75-year-old woman with a history of recurrent spontaneous abortions and smoking was referred to our hospital for the treatment of symmetric peripheral gangrene in all four extremities. Her painful digital and toe gangrene developed over 2 weeks (figure 1). Her peripheral pulses were absent, and angiography revealed total occlusion of the palmar and pedal arches (figure 1). Concomitant deep vein thrombosis …
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