Unheralded Lower limb threatening ischemia in a COVID-19 patient
Andrea Vacirca, Gianluca Faggioli, Rodolfo Pini, Paolo Teutonico, Alessandro Pilato, Mauro Gargiulo, Andrea Vacirca, Gianluca Faggioli, Rodolfo Pini, Paolo Teutonico, Alessandro Pilato, Mauro Gargiulo
Abstract
Acute thromboembolic events appear to be frequent in patients with SARS-CoV-2 infection. We report a case of an intubated patient, who developed a threatening lower limb ischemia. Intra-arterial fibrinolysis and intravenous heparin infusion did not lead to complete recanalization of the tibial arteries, which were successfully treated by surgical embolectomy.
Keywords: Acute limb ischemia; COVID-19; SARS-CoV-2 infection; Thrombosis.
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
Figures
References
- Björck M., Earnshaw J.J., Acosta S., Bastos Gonçalves F., Cochennec F., Debus E.S. European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia. Eur J Vasc Endovasc Surg. 2020;59(2):173–218.
- Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
- Tang N., Li D., Wang X., Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–847.
- Tang N., Bai H., Chen X., Gong J., Li D., Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020 Mar 27.
- Thachil J. The versatile heparin in COVID-19. J Thromb Haemost. 2020 Apr 2.
- Wu C., Chen X., Cai Y., Xia J., Zhou X., Xu S. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020 Mar 13. doi: 10.1001/jamainternmed.2020.0994.
- Zhang Y., Xiao M., Zhang S., Xia P., Cao W., Jiang W. Coagulopathy and antiphospholipid antibodies in patients with Covid-19. N Engl J Med. 2020 Apr 8.
Source: PubMed