Warrior Krishnan, Chung Paul A, Ahmed Nida, Soult Michael C, Simpson Kevin P
Division of Pulmonary and Critical Care, Department of Medicine, Loyola University Health System, Stritch School of Medicine, Maywood, IL.
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Loyola University Health System, Stritch School of Medicine, Maywood, IL.
Crit Care Explor. 2020 Jun 11;2(6):e0140. doi: 10.1097/CCE.0000000000000140. eCollection 2020 Jun.
To describe a case of acute limb ischemia caused by arterial thrombosis due to coronavirus disease 2019.
Clinical observation of a patient.
Academic medical center.
A 59-year-old female with history of hypertension, hyperlipidemia, and prior smoking.
Clinical observation and data extraction from electronic medical records.
We report a case of peripheral arterial thrombosis associated with coronavirus disease 2019, resulting in acute limb ischemia of the right lower extremity. This event was heralded by a sudden and significant elevation in d-dimer levels. At the time of surgery, a long, gelatinous clot was retrieved from the right popliteal artery. Perioperatively, she continued to have absent pedal Doppler signals and after multiple embolectomy attempts, required distal arterial cut down with removal of additional thrombi and resultant improvement of distal arterial flow.
This case demonstrates the importance of regularly checking d-dimer levels and vigilant monitoring for arterial thrombotic events, as they can rapidly become catastrophic.
描述一例由2019冠状病毒病导致动脉血栓形成引起的急性肢体缺血病例。
对一名患者的临床观察。
学术医疗中心。
一名59岁女性，有高血压、高脂血症病史，既往有吸烟史。
临床观察及从电子病历中提取数据。
我们报告一例与2019冠状病毒病相关的外周动脉血栓形成病例，导致右下肢急性肢体缺血。此事件以D-二聚体水平突然显著升高为先兆。手术时，从右腘动脉取出一个长的凝胶状血栓。围手术期，她的足部多普勒信号持续消失，在多次尝试取栓后，需要进行远端动脉切开以清除额外的血栓，从而改善远端动脉血流。
本病例表明定期检查D-二聚体水平以及对动脉血栓形成事件进行 vigilant监测的重要性，因为这些事件可能迅速变得灾难性。
