Vascular Division, Department of Cardiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Gonda Vascular Center, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
J Thromb Thrombolysis. 2021 May;51(4):985-988. doi: 10.1007/s11239-021-02388-5. Epub 2021 Jan 30.
Infection with the SARS-COV2 virus (COVID-19) may be complicated by thrombotic diathesis. This complication often involves the pulmonary microcirculation. While macrovascular thrombotic complications of the lung may include pulmonary artery embolism, pulmonary artery thrombus in situ has also been hypothesized. Pulmonary vein thrombosis has not been described in this context.
METHODS/RESULTS: Herein, we provide a case of an otherwise healthy male who developed an ischemic stroke with left internal carotid thrombus. Further imaging revealed pulmonary emboli with propagation through the pulmonary veins into the left atrium. This left atrial thrombus provides a source of atypical "paradoxic arterial embolism".
Thrombotic outcomes in the setting of severe COVID 19 pneumonia may include macrovascular venous thromboembolism, microvascular pulmonary vascular thrombosis and arterial thromboembolism. Pulmonary vein, herein described, provides further mechanistic pathway for potential arterial embolic phenomenon.
感染 SARS-COV2 病毒（COVID-19）可能伴有血栓形成倾向。这种并发症常涉及肺微循环。虽然肺的大血管血栓并发症可能包括肺动脉栓塞，但也有人假设存在肺动脉原位血栓。在这种情况下，尚未描述肺静脉血栓形成。
方法/结果：在此，我们提供了一例原本健康的男性患者，他发生了伴有左侧颈内动脉血栓形成的缺血性脑卒中。进一步的影像学检查显示存在肺栓塞，栓子通过肺静脉传播至左心房。该左心房血栓为非典型“反常性动脉栓塞”提供了来源。
严重 COVID-19 肺炎患者的血栓形成结局可能包括大血管静脉血栓栓塞、微血管肺血管血栓形成和动脉血栓栓塞。在此描述的肺静脉为潜在动脉栓塞现象提供了进一步的机制途径。
