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Updated: Jul 31, 2025

Methods for Acute and Subacute Murine Hindlimb Ischemia
Published on: June 21, 2016
COVID-19 related acute limb ischaemia: A case series
Jih Huei Tan1, Henry Chor Lip Tan2, Addy Aun Wei Ang3
1MBBS (Manipal), DrSurg (UKM), Department of General Surgery, Hospital Sultanah Aminah, Jalan Masjid Sultan Abu Bakar, Johor Bahru, Malaysia.
Insights
COVID-19 infection and vaccination rarely cause acute limb ischemia, but a Malaysian hospital saw an increase during high COVID-19 rates. Early anticoagulation and heightened awareness can minimize this risk.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Public Health
Background:
- Arterial occlusive disease of the extremities is rarely linked to COVID-19 infection or vaccination.
- A Malaysian hospital observed a surge in COVID-19-related acute limb ischemia during periods of high local and international COVID-19 transmission.
- Clinical data on acute limb ischemia associated with COVID-19 in Johor, Malaysia, remain limited.
Abstract:
COVID-19 infection or vaccination is rarely associated with arterial occlusive disease of the extremities. The surgical department of a hospital in Johor, Malaysia, recorded a significant increase in the number of COVID-19-related acute limb ischaemia when the rates of COVID-19 were high both locally and internationally. The clinical presentation and management of acute limb ischaemia associated with COVID-19 infection or vaccination are largely underreported in Johor. Herein, we report a case series of 12 patients managed with strategies ranging from purely anticoagulation to catheter-directed thrombolysis and surgical embolectomy. This case series describes the clinical presentation, risk profiles, treatment approaches and limb outcomes of the patients. The amputation rate was high in view of unfavourable factors, including delayed presentation, high-risk factors and severe COVID-19. Three cases of potential COVID-19 vaccine-related acute limb ischaemia were included. COVID-19-related acute limb ischaemia can be minimised with heightened alert, preemptive optimisation with proper hydration and consideration for early prophylactic anticoagulation in high-risk cases.
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