A review of acute limb ischemia in COVID-positive patients. Review uri icon

Overview

abstract

  • This literature review discusses the current evidence on acute limb ischemia (ALI) in patients with COVID-19. Throughout the pandemic, these patients have been at increased risk of arterial thrombotic events and subsequent mortality as a result of a hypercoagulable state. The exact mechanism of thrombosis is unknown; however arterial thrombosis may be due to invasion of endothelial cells via angiotensin-converting enzyme 2 (ACE2) receptors, endothelial injury from inflammation, or even free-floating aortic thrombus. Multiple studies have been performed evaluating the medical and surgical management of these patients; the decision to proceed with operative intervention is dependent on the patient's clinical status as it relates to COVID-19 and morbidity of that disease. The interventions afforded typically include anticoagulation in patients undergoing palliation; alternatively, thrombectomy (endovascular and open) is utilized in other patients. There is a high risk of rethrombosis, despite anticoagulation, given persistent endothelial injury from the virus. Postoperative mortality can be high in these patients.

authors

  • Ilonzo, Nicole
  • Judelson, Dejah
  • Al-Jundi, Wissam
  • Etkin, Yana
  • O'Banion, Leigh Anne
  • Rivera, Aksim
  • Tinelli, Giovanni
  • Bellosta, Rafaello
  • Vouyouka, Ageliki

publication date

  • May 20, 2021

Research

keywords

  • COVID-19
  • Ischemia
  • Lower Extremity
  • Thrombosis

Identity

PubMed Central ID

  • PMC8167656

Scopus Document Identifier

  • 85107329833

Digital Object Identifier (DOI)

  • 10.1016/j.avsg.2021.01.067

PubMed ID

  • 34144749

Additional Document Info

volume

  • 34

issue

  • 2