Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 is the virus responsible for the 2019 global pandemic. Pulmonary complications of COVID-19 are well established in the literature. However, the virus causes numerous extrapulmonary manifestations, notably acute aortic occlusion (AAO). COVID-19 creates a hypercoagulable state via the upregulation of numerous procoagulant cytokines in endothelial cells of blood vessels. We present a case of a 63-year-old patient without a previous history of prothrombotic disorders who developed AAO in the distal abdominal aorta and bilateral common iliac arteries after contracting COVID-19. The patient was a poor surgical candidate and was treated with fibrinolytics that were administered via an EkoSonic™ Endovascular System (EKOS) catheter using a bilateral transfemoral approach. This case highlights a unique treatment option for non-surgical candidates with AAO.
Highlights
Acute aortic occlusion (AAO) has a multitude of etiologies including aortic emboli, thrombosis of an atherosclerotic plaque, aortic stent occlusion and aortic dissection [1,2]
Acute aortic occlusion has been linked as an extrapulmonary manifestation of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) or COVID-19
Aortobifemoral bypass and thrombolysis are all viable treatment options that are well described in the literature [1,2]
Summary
Acute aortic occlusion (AAO) has a multitude of etiologies including aortic emboli, thrombosis of an atherosclerotic plaque, aortic stent occlusion and aortic dissection [1,2]. We present a case of a 63-year-old patient that developed AAO secondary to COVID-19 infection This case represents a unique way of treating AAO using fibrinolytics administered through an EKOS catheter using a bilateral transradial approach. A 63-year-old female with newly diagnosed atrial fibrillation with rapid ventricular response (RVR), history of type 2 diabetes, hypertension, and deep venous thrombosis six years ago presented to the emergency department with paresthesia of the left lower extremity. She had been feeling sick over the last few days with a sore throat, cough, and shortness of breath. It is unknown whether or not the patient was vaccinated against COVID-19
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