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Acute Peripheral Arterial Thrombosis in COVID-19 Patients on Therapeutic Anticoagulation

Abhyuday Kumar1, Neeraj Kumar2, Shettru K Arun1

  • 1Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, Bihar, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|May 28, 2021
PubMed

Insights

Severe COVID-19 can cause rare arterial clots even with anticoagulation. Prompt intervention like thrombectomy may be needed for limb-threatening arterial thrombosis in these patients.

Area of Science:

  • Vascular Medicine
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease-2019 (COVID-19) is frequently associated with venous thromboembolism.
  • Arterial thrombosis is an uncommon complication, particularly in patients receiving therapeutic anticoagulation.

Observation:

  • Two cases of acute peripheral arterial thrombosis in patients with COVID-19 on therapeutic low-molecular-weight heparin are presented.
  • One patient developed radial artery thrombosis affecting the hand, while the other experienced anterior tibial artery thrombosis leading to limb amputation.

Findings:

  • Both patients demonstrated limited response to additional heparin infusion.
  • These cases highlight the potential for severe arterial thrombosis despite standard anticoagulation therapy in COVID-19.

Implications:

  • Consider intensified anticoagulation strategies for high-risk COVID-19 patients prone to venous thrombosis.
  • Early consideration of interventional thrombectomy is crucial for managing arterial thrombosis unresponsive to pharmacological treatment.

Keywords:
ArteryCOVID-19Intensive careLow-molecular-weight heparinThrombosis

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