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COVID-19-Related Spontaneous Aortic Arch Thrombus With Delayed Embolization
Bilal S Siddiq1, Matthew Ward2, Matthew Blecha3
1College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
The American Surgeon
|July 26, 2021
Summary
A COVID-19 patient with chronic obstructive pulmonary disease developed aortic and tibial artery thrombosis. Successful treatment involved anticoagulation and mechanical thrombectomy, leading to thrombus resolution.
Area of Science:
- Cardiology
- Pulmonology
- Infectious Diseases
Background:
- A 62-year-old male with chronic obstructive pulmonary disease (COPD) presented with dyspnea and new COVID-19 infection.
- Chest CT was performed to evaluate for pulmonary embolism, revealing an aortic arch mural thrombus.
Observation:
- The patient was treated with therapeutic anticoagulation and managed for hypoxia.
- One month later, he presented with critical limb ischemia in the right foot due to tibial artery thrombosis.
Findings:
- Percutaneous mechanical thrombectomy and thrombolysis successfully restored flow in one tibial artery.
- The remaining tibial arteries autolysed with continued anticoagulation, and the aortic thrombus resolved within 4 months.
Implications:
- This case highlights the potential for severe thrombotic events in COVID-19 patients, even those with underlying COPD.
- Prompt anticoagulation and targeted revascularization strategies can be effective in managing arterial thrombosis associated with COVID-19.
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