Systemic Thrombolysis as Initial Treatment of COVID-19 Associated Acute Aortoiliac and Lower Extremity Arterial Thrombosis

Ann Vasc Surg. 2021 Jan:70:297-301. doi: 10.1016/j.avsg.2020.08.083. Epub 2020 Aug 28.

Abstract

SARS-CoV-2 (COVID-19) patients with associated thromboembolic events have demonstrated poor outcomes despite the use of anticoagulation therapy and surgical intervention. We present a COVID-19 patient with acute limb ischemia, secondary to extensive thrombosis of an aortic aneurysm, iliac arteries, and infrainguinal arteries. Initial treatment with systemic thrombolysis, which restored patency of the aortoiliac occlusion, was followed by open thrombectomies of the infrainguinal occlusions.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Aneurysm, Abdominal / complications*
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / drug therapy*
  • Arterial Occlusive Diseases / etiology
  • Arterial Occlusive Diseases / physiopathology
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • Fibrinolytic Agents / administration & dosage*
  • Humans
  • Iliac Artery* / diagnostic imaging
  • Iliac Artery* / physiopathology
  • Infusions, Intravenous
  • Male
  • Thrombectomy
  • Thrombolytic Therapy*
  • Thrombosis / diagnostic imaging
  • Thrombosis / drug therapy*
  • Thrombosis / etiology
  • Thrombosis / physiopathology
  • Tissue Plasminogen Activator / administration & dosage*
  • Treatment Outcome
  • Vascular Patency

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator