Nicole Ilonzo, Dejah Judelson, Wissam Al-Jundi, Yana Etkin, Leigh Anne O'Banion, Aksim Rivera, Giovanni Tinelli, Rafaello Bellosta, Ageliki Vouyouka
Seminars in vascular surgery 2021 JunThis 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. Copyright © 2021 Elsevier Inc. All rights reserved.
Nicole Ilonzo, Dejah Judelson, Wissam Al-Jundi, Yana Etkin, Leigh Anne O'Banion, Aksim Rivera, Giovanni Tinelli, Rafaello Bellosta, Ageliki Vouyouka. A review of acute limb ischemia in COVID-positive patients. Seminars in vascular surgery. 2021 Jun;34(2):8-12
PMID: 34144749
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