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Acute Limb Ischemia in a COVID-19 Patient: A Case Report

Naohiro Akita1, Takuya Osawa1, Hirona Todoroki1

  • 1Department of Vascular Surgery, Toyota Kosei Hospital, Toyota, Aichi, Japan.

Annals of Vascular Diseases
|January 27, 2022
PubMed

Insights

A coronavirus disease 2019 patient experienced severe limb pain and paralysis due to arterial thrombosis. Despite emergency intervention, thrombosis recurred, leading to multiple organ failure and death.

Area of Science:

  • Vascular surgery
  • Infectious diseases
  • Critical care medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with hypercoagulable states.
  • Arterial thrombosis is a rare but serious complication of COVID-19.
  • Iliac artery occlusion and aortic stenosis can lead to critical limb ischemia.

Purpose of the Study:

  • To report a case of severe arterial thrombosis in a COVID-19 patient.
  • To highlight the challenges in managing thrombotic complications in COVID-19.
  • To discuss the potential link between COVID-19 and arterial thrombosis.

Main Methods:

  • A 63-year-old male with confirmed COVID-19 presented with acute limb ischemia.
  • Computed tomography angiography revealed right common iliac artery occlusion and abdominal aorta stenosis.
  • Emergency angiography and thrombectomy were performed, followed by intensive care unit management.

Main Results:

  • Successful thrombectomy was initially achieved.
  • The patient required mechanical ventilation and hemodialysis for renal failure.
  • Recurrent thrombosis occurred on postoperative day 7, resulting in multiple organ failure and death.

Conclusions:

  • COVID-19 may predispose patients to severe arterial thrombosis.
  • Prompt diagnosis and intervention are crucial for managing acute limb ischemia in COVID-19 patients.
  • Recurrent thrombosis and multiorgan failure remain significant risks despite treatment.

Keywords:
COVID-19acute limb ischemiaarterial thrombosis

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