Abstract
Since the coronavirus pandemic set in in Spain in March 2020, a noteworthy increase in the incidence of acute limb ischemia (ALI) has been observed. It has been recently discovered that SARS-CoV 2 may lead to ALI secondary to arterial thrombosis. Elevation of D-dimer (DD) in patients with coronavirus infection (COVID-19) indicates that a hypercoagulable state causes acute arterial thrombosis. A remarkably high DD elevation has been reported to be a poor prognosis factor in COVID-19. The ways in which SARS-CoV 2 results in arterial thrombosis may be multiple. On the other hand, surgical revascularization for ALI is associated with poor outcomes in COVID-19 patients, probably in relation to hypercoagulability. Here, we describe two ALI cases in patients who required urgent surgical treatment for limb salvage and were positive for the novel coronavirus infection (COVID 19).
Highlights
Since the coronavirus pandemic set in in Spain in March 2020, a significant increase in the incidence of acute limb ischemia (ALI) has been observed
COVID-19 caused by SARS-CoV-2 has led to a pandemic, infecting over 3 million humans globally and causing over 240,000 deaths by early May of 2020.1
The ways in which SARS-CoV 2 leads to acute arterial thrombosis may be multiple: First, virus infections are accompanied by an aggressive pro-inflammatory response and insufficient anti-inflammatory response
Summary
Since the coronavirus pandemic set in in Spain in March 2020, a significant increase in the incidence of acute limb ischemia (ALI) has been observed. We describe two ALI cases in patients with coronavirus infection (COVID-19). A 70-year-old woman presented to the emergency department with right lower limb pain and coldness for 3 days. Fatigue or dyspnea was elicited; she had presented fever 9 days previously. She had a medical history of diabetes mellitus and hyperlipidemia. The right leg looked pale from the level of the knee. All right lower extremity pulses were absent. The patient’s angio-CT scan demonstrated mural aortic thrombus at the infrarenal abdominal aorta as well as thrombotic occlusion of the right iliac artery and infrapopliteal vessels (Figures 1 and 2). By means of a Fogarty embolectomy catheter (Le Maitre®; Burlington, MA, USA), an extensive thrombus was
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