COVID-19 疾病中的主动脉血栓形成：一种戏剧性的血管并发症。
Aortic thrombosis as a dramatic vascular complication in COVID-19 disease.
机构信息
Université Paris Cité, Paris, France; Assistance Publique-hôpitaux de Paris, hôpital Européen Georges Pompidou, Departments of Vascular Medicine and Vascular Surgery, Paris, France; Inserm UMR_S 1140, Innovations Thérapeutiques en Hémostase, Fondation Carpentier, laboratoire de recherches biochirurgicales, Paris, France.
Université Paris Cité, Paris, France; Assistance Publique-hôpitaux de Paris, hôpital Européen Georges Pompidou, Departments of Vascular Medicine and Vascular Surgery, Paris, France; Inserm UMR_S 1140, Innovations Thérapeutiques en Hémostase, Fondation Carpentier, laboratoire de recherches biochirurgicales, Paris, France.
出版信息
J Med Vasc. 2022 Oct;47(4):169-174. doi: 10.1016/j.jdmv.2022.10.003. Epub 2022 Oct 11.
OBJECTIVE
To report clinical outcomes of COVID-19 related acute aortic thrombosis (AAT).
METHODS
Consecutive COVID-19 patients presenting with AAT between April 2020 and August 2021 were included retrospectively. Clinical and radiological data were prospectively collected.
RESULTS
Ten patients (men, 90%; mean age, 64 ± 2 years) were included. At the time of AAT diagnosis, four patients were in intensive care unit. Median time between diagnosis of COVID-19 and AAT was 5 days [IQR 0-8.5]. Clinical presentation was acute lower limb ischaemia (n=9) and mesenteric ischaemia (n=2). Thrombus localization was the abdominal aorta (n=5), the thoracic aorta (n=2) or both (n=3), with the following embolic sites: lower limbs (n=9), renal arteries (n=3), superior mesenteric artery (n=2), splenic artery (n=1), cerebral arteries (n=1). Revascularization was performed in 9 patients, using open (n=6), endovascular (n=2) or hybrid techniques (n=1). Three patients required reinterventions. The 30-day mortality was 30%. Three major amputations were performed in two patients, resulting in a free-amputation survival rate of 50% after a median follow-up of 3,5 months [IQR 2-4.1].
CONCLUSION
AAT is a rare and devastating complication of COVID-19 disease, responsible for high mortality and amputation rates.
目的
报告 COVID-19 相关急性主动脉血栓形成（AAT）的临床结果。
方法
回顾性纳入 2020 年 4 月至 2021 年 8 月期间连续出现 AAT 的 COVID-19 患者。前瞻性收集临床和影像学数据。
结果
共纳入 10 例患者（男性占 90%；平均年龄 64±2 岁）。在 AAT 诊断时，有 4 例患者在重症监护病房。COVID-19 诊断与 AAT 之间的中位时间为 5 天[IQR 0-8.5]。临床表现为急性下肢缺血（n=9）和肠系膜缺血（n=2）。血栓定位在腹主动脉（n=5）、胸主动脉（n=2）或两者（n=3），以下为栓塞部位：下肢（n=9）、肾动脉（n=3）、肠系膜上动脉（n=2）、脾动脉（n=1）、脑动脉（n=1）。9 例患者进行了血运重建，采用开放（n=6）、血管内（n=2）或杂交技术（n=1）。3 例患者需要再次介入治疗。30 天死亡率为 30%。2 例患者进行了 3 次大截肢，中位随访 3.5 个月[IQR 2-4.1]后，无截肢生存率为 50%。
结论
AAT 是 COVID-19 疾病的一种罕见且严重的并发症，导致高死亡率和截肢率。
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