Aortic thrombosis as a dramatic vascular complication in COVID-19 disease - 05/11/22
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Highlights |
• | AAT is a devastating complication of COVID-19 infection, and occurs in patients with cardiovascular risk factors. |
• | The overall mortality rate and the amputation rate at 30 days are 30% in this cohort. |
• | AAT is an early complication of COVID-19 infection, and when it occurs consequences are dramatic (bowel disruption, amputation, death). |
Summary |
Objective |
To report clinical outcomes of COVID-19 related acute aortic thrombosis (AAT).
Methods |
Consecutive COVID-19 patients presenting with AAT between April 2020 and August 2021 were included retrospectively. Clinical and radiological data were prospectively collected.
Results |
Ten patients (men, 90%; mean age, 64 ± 2 years) were included. At the time of AAT diagnosis, four patients were in intensive care unit. Median time between diagnosis of COVID-19 and AAT was 5 days [IQR 0–8.5]. Clinical presentation was acute lower limb ischaemia (n=9) and mesenteric ischaemia (n=2). Thrombus localization was the abdominal aorta (n=5), the thoracic aorta (n=2) or both (n=3), with the following embolic sites: lower limbs (n=9), renal arteries (n=3), superior mesenteric artery (n=2), splenic artery (n=1), cerebral arteries (n=1). Revascularization was performed in 9 patients, using open (n=6), endovascular (n=2) or hybrid techniques (n=1). Three patients required reinterventions. The 30-day mortality was 30%. Three major amputations were performed in two patients, resulting in a free-amputation survival rate of 50% after a median follow-up of 3,5 months [IQR 2–4.1].
Conclusion |
AAT is a rare and devastating complication of COVID-19 disease, responsible for high mortality and amputation rates.
Le texte complet de cet article est disponible en PDF.Keywords : COVID-19 disease, Vascular complication, Acute aortic thrombosis, Arterial thrombosis, Mortality
Plan
Vol 47 - N° 4
P. 169-174 - octobre 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.