12248Stritch School of Medicine, Loyola University Chicago, IL, USA.
Division of Vascular Surgery and Endovascular Therapy, Loyola University Chicago, IL, USA.
Vasc Endovascular Surg. 2021 Oct;55(7):781-786. doi: 10.1177/15385744211010445. Epub 2021 Apr 13.
The optimal management strategy of acute limb ischemia in non-ventilated patients with COVID-19 is uncertain. We propose that non-ventilated patients who develop COVID-19 related spontaneous arterial thrombosis with associated limb threat may be best suited with percutnaeous revascularization to achieve limb salvage. Herein we describe 5 cases of patients who had severely threatened limbs with complete thrombosis of all 3 tibial arteries who were treated with percutaneous revascularization. All 5 patients were felt to be facing inevitable amputation without revascularization should they survive their COVID hospitalization. We were able to achieve limb salvage in all 5 patients selected for therapy, although 2 ultimately succumbed to respiratory failure.
COVID-19 非通气患者急性肢体缺血的最佳治疗策略尚不确定。我们提出,对于因 COVID-19 导致自发性动脉血栓形成并伴有肢体威胁的非通气患者,可能最适合采用经皮血运重建以实现肢体挽救。在此,我们描述了 5 例严重威胁肢体的患者,他们的所有 3 条胫骨动脉均完全血栓形成,采用经皮血运重建治疗。如果这些患者在 COVID 住院期间不接受血运重建,所有 5 例患者都将面临不可避免的截肢。我们对所有选择接受治疗的 5 例患者均实现了肢体挽救,尽管最终有 2 例患者因呼吸衰竭而死亡。