Achim Alexandru, Kákonyi Kornél, Jambrik Zoltán, Ruzsa Zoltán
Invasive Cardiology Division, Internal Medicine Department, Faculty of Medicine, University of Szeged, Semmelweis Str 6, 6726, Szeged, Hungary.
Niculae Stancioiu Heart Institute, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
Eur Heart J Case Rep. 2022 Feb 23;6(3):ytac099. doi: 10.1093/ehjcr/ytac099. eCollection 2022 Mar.
Several coronavirus disease-19 (COVID-19)-associated complications are being increasingly reported, including arterial and venous thrombo-embolic events that may lead to amputation of the affected limbs. So far, acute upper limb ischaemia (ULI) has been reported only in critically ill patients.
Herein, we aimed to present a case of a 29-year-old, otherwise healthy male volleyball player, with acute ischaemic signs in the upper extremity who was diagnosed with COVID-19 1 month before the ischaemic event. It has been shown that volleyball players experience repetitive stress that involves their hands and, in particular, their fingers. Repetitive trauma can lead to local vascular abnormalities, such as reduced capillarization and lower resting blood flow that can lead to pain and cold digits, but never acute ULI.
To our knowledge, this is the first case of such a hypercoagulable synergistic mechanism that leads to a high thrombus burden. Intra-arterial local thrombolysis and percutaneous transluminal angioplasty failed to succeed, and percutaneous large-bore embolectomy with the Indigo Aspiration System (Penumbra Inc., CA, USA) was deemed necessary.
新型冠状病毒肺炎（COVID-19）相关的几种并发症报告日益增多，包括可能导致患肢截肢的动脉和静脉血栓栓塞事件。到目前为止，急性上肢缺血（ULI）仅在危重症患者中被报道。
在此，我们旨在介绍一例29岁、原本健康的男性排球运动员，其上肢出现急性缺血体征，在缺血事件发生前1个月被诊断为COVID-19。研究表明，排球运动员手部尤其是手指会经历重复性压力。重复性创伤可导致局部血管异常，如毛细血管化减少和静息血流降低，进而导致疼痛和手指发冷，但从未引发急性ULI。
据我们所知，这是首例由这种高凝协同机制导致高血栓负荷的病例。动脉内局部溶栓和经皮腔内血管成形术均未成功，因此认为有必要使用Indigo抽吸系统（美国加利福尼亚州Penumbra公司）进行经皮大口径取栓术。
