Soumer K, Mallouki M, Azabou N, Horchani H, Nsiri S, Bousnina M, Jemel A
Department of Cardiovascular Surgery, Abderrahman Mami Hospital, Ariana, Tunisia.
Department of Visceral Surgery, Mahmoud El Matri Hospital, Ariana, Tunisia.
Gen Thorac Cardiovasc Surg. 2025 Mar;73(3):164-170. doi: 10.1007/s11748-024-02072-4. Epub 2024 Aug 14.
Thromboembolic events of COVID-19 are due to hyperinflammatory process associated with hypercoagulable state. The aim of the study was to determine characteristics and clinical outcomes of patients with COVID-19 who presented with aortic thrombus.
We retrospectively conducted a single-center, descriptive study over a period of 1 year and 7 months, between June 2021 and December 2022, involving eight patients with documented SARS-CoV-2 infection associated with aortic thrombus revealed by acute limb ischemia.
The mean age of patients was 67 years with a median of 64, 5 ± 14. Of the eight included patients, six were men and two were women. Aortic thrombus was diagnosed in all cases. Six patients developed one episode of acute limb ischemia and one patient had recurrent upper and lower ischemia despite full anticoagulation whereas one patient had distal embolization with palpable pulses. In six patients, the thrombi were located in descending and abdominal aorta, while two patients presented with ascending aorta floating thrombus. Seven patients required urgent revascularization whereas medical treatment was recommended for one patient. The primary outcomes were successful in five cases, one patient had to be amputated above elbow, whereas two patients died due to a rapid deterioration of respiratory condition.
Aortic thrombosis is a rare clinical presentation in SARS-CoV-2 infection but with potentially fatal embolic complication. Physicians should maintain a high degree of clinical suspicion to diagnose thromboembolic consequences of SARS-CoV-2 infection for timely management and avoiding morbidities like ischemic stroke and major amputations.
新型冠状病毒肺炎（COVID-19）的血栓栓塞事件是由与高凝状态相关的炎症反应过度所致。本研究的目的是确定出现主动脉血栓的COVID-19患者的特征和临床结局。
我们于2021年6月至2022年12月期间进行了一项为期1年零7个月的单中心描述性回顾性研究，纳入8例经记录证实感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）且伴有急性肢体缺血所揭示的主动脉血栓形成的患者。
患者的平均年龄为67岁，中位数为64.5±14岁。纳入的8例患者中，6例为男性，2例为女性。所有病例均诊断为主动脉血栓形成。6例患者发生1次急性肢体缺血，1例患者尽管接受了充分抗凝治疗仍反复出现上下肢缺血，而1例患者出现伴有可触及脉搏的远端栓塞。6例患者的血栓位于降主动脉和腹主动脉，2例患者表现为升主动脉漂浮血栓。7例患者需要紧急血管重建，而1例患者建议进行药物治疗。5例患者取得了主要治疗效果，1例患者不得不进行肘部以上截肢，2例患者因呼吸状况迅速恶化而死亡。
主动脉血栓形成在SARS-CoV-2感染中是一种罕见的临床表现，但具有潜在致命的栓塞并发症。医生应保持高度的临床怀疑，以诊断SARS-CoV-2感染的血栓栓塞后果，以便及时进行治疗并避免诸如缺血性卒中和大截肢等并发症。
