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一名因多发性骨盆骨折植入可回收滤器的患者发生与新型冠状病毒肺炎感染相关的广泛下腔静脉血栓形成。

Extensive Inferior Vena Cava Thrombosis Related to COVID-19 Infection in a Patient with Retrievable Filter Due to Multiple Pelvic Bone Fractures.

作者信息

Georgiadis George S, Argyriou Christos, Tottas Stylianos, Foutzitzi Soultana, Drosos Georgios

机构信息

Department of Vascular Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.

Department of Orthopaedic Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.

出版信息

Vasc Specialist Int. 2022 Mar 24;38:4. doi: 10.5758/vsi.210070.

Abstract

Inferior vena cava (IVC) thrombosis is often attributed to IVC filters. Here, we describe the first case of IVC filter thrombosis associated with severe acute respiratory syndrome coronavirus-2 infection in a 34-year-old male with multiple pelvic fractures. The IVC filter was initially placed prophylactically prior to major orthopedic trauma reconstruction complicated by silent pulmonary embolism, precluding the safe transition to therapeutic anticoagulation due to the high hemorrhagic risk from pelvic fracture fixation. This case highlights the potentially increased risk of severe complications in patients receiving vascular care if they were to contract coronavirus disease-2019 (COVID-19) in the hospital. IVC filter placement in the patient resulted in complete IVC thrombosis after he acquired COVID-19 infection. Prophylactic doses of low molecular weight heparin could not prevent this complication. However, prompt initiation of therapeutic anticoagulation with rivaroxaban led to the complete resolution of IVC thrombosis over weeks after viral negativization and discharge.

摘要

下腔静脉(IVC)血栓形成常归因于IVC滤器。在此,我们描述了首例与严重急性呼吸综合征冠状病毒2感染相关的IVC滤器血栓形成病例,患者为一名34岁男性,有多处骨盆骨折。IVC滤器最初是在复杂的重大骨科创伤重建手术前预防性放置的,该手术并发无症状肺栓塞,由于骨盆骨折固定导致的高出血风险,无法安全过渡到治疗性抗凝。该病例突出了在医院感染2019冠状病毒病(COVID-19)的患者接受血管护理时,严重并发症的潜在风险可能增加。患者在感染COVID-19后,IVC滤器置入导致下腔静脉完全血栓形成。预防性剂量的低分子量肝素未能预防这一并发症。然而,在病毒转阴并出院后数周内,立即开始使用利伐沙班进行治疗性抗凝,导致下腔静脉血栓完全消退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b4/8947959/c06046adcb58/vsi-38-4-f1.jpg

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