scholarly journals Acute Lower Limb Ischemia Secondary to COVID-19: A Case Report

2021 ◽  
Vol 11 (6) ◽  
pp. 161-163
Author(s):  
Komal Gharsangi ◽  
Rajesh Bhawani ◽  
Nitesh Kumar
Keyword(s):  
Lower Limb ◽  
Distress Syndrome ◽  
Multiorgan Failure ◽  
Clinical Manifestations ◽  
Limb Ischemia ◽  
Respiratory Illness ◽  
Acute Limb Ischemia ◽  
Poor Clinical Outcome ◽  
Rare Manifestation ◽  
Thrombotic Complications

COVID -19 is not just a respiratory illness; it is a great masquerader with clinical manifestations from pneumonia, acute respiratory distress syndrome to endothelial dysfunction, hypercoagulability and multiorgan failure. Thrombotic complications due to Covid related coagulopathy is of concern as it further leads to poor clinical outcome in severe cases of Covid 19. Acute limb ischemia (ALI) is a rare manifestation of Covid related coagulopathy. Key words: COVID, coagulopathy, acute limb ischemia (ALI).

Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis – case report and systematic review of dabigatran use

VASA ◽  
2020 ◽  
pp. 1-6 ◽  
Author(s):  
Marina Di Pilla ◽  
Stefano Barco ◽  
Clara Sacco ◽  
Giovanni Barosi ◽  
Corrado Lodigiani
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Review Of The Literature ◽  
Heparin Induced Thrombocytopenia ◽  
Lower Limb Ischemia ◽  
Vein Thrombosis ◽  
Left Lower Limb

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

scholarly journals A case of acute limb ischemia

2021 ◽  
Vol 8 (10) ◽  
pp. 1608
Author(s):  
Kshiti Rai ◽  
K. G. Sajeeth Kumar ◽  
Danish Ekkalayil ◽  
Anoop Chanthu K. K.
Keyword(s):  
Acute Myeloid Leukemia ◽  
Early Diagnosis ◽  
Lower Limb ◽  
Myeloid Leukemia ◽  
Hematological Malignancy ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Rare Presentation ◽  
Hematological Evaluation ◽  
Acute Myeloid

Thromboembolism is a well-recognized complication of hematological malignancy. The incidence of symptomatic thrombosis at diagnosis is relatively low in AML (acute myeloid leukemia) patients, though its incidence increases on treatment with anthracyclines. We reported a case of 69 year old female with T2DM who presented with DVT and later on acute limb ischemia of the same lower limb. On hematological evaluation, she had leukocytosis and thrombocytopenia. Further evaluation revealed AML. Thromboembolism as a rare presentation of AML in adults with leukemic hyperleukocytosis has seldom been reported. In the absence of clear guidelines, early diagnosis and management are desirable.

scholarly journals P853 Bilateral lower limb ischemia in a healthy young man what if the heart was hiding the etiology

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Mouadili ◽  
A Tamdy ◽  
B El Fatmi ◽  
S Elkarimi
Keyword(s):  
Popliteal Artery ◽  
Lower Limb ◽  
Cardiac Myxoma ◽  
Clinical Manifestations ◽  
Limb Ischemia ◽  
Atrial Myxoma ◽  
Surgical Removal ◽  
Left Atrial Myxoma ◽  
Tibial Arteries ◽  
The Right

Abstract Cardiac myxoma is the most common benign cardiac tumor with diverse nonspecific clinical manifestations; moreover, atrial myxoma embolization to the peripheral vessels is rare. A 24-year-old man presented tothe emergency departement complaining ofpain and coldness of his two lower extremities. The right femoral pulse was normally felt while the pulses of the left lower limb from the femoral down to the posterior and anterior tibial arteries were not felt. Bilateral thrombectomy was performed on emergency basisand a fatty-like mass from the left femoral artery was removed. The histological examination of this mass was suggestive of myxoma.So, transthoracic echocardiography was done and confirmed the diagnosis of myxoma that was seen in the left atrium and measuring about 10X6 cm in its maximal dimensions. Surgical removal of the myxoma was done later and the patient recovered uneventfully. Conclusion Although myxomas are rare, they should be considered in the differential diagnosis of peripheral embolic disease, especially when an embolic event occurs in a young adult without evidence of endocarditis or arrhythmia. Echocardiography is the modality of choice for diagnosis and follow-up of this type of tumors. FIGURE 1: CTA (computed tomography angiography) showing Occlusion of the left popliteal artery and occlusion of the distal part of the right popliteal artery FIGURE 2: macroscopic view of gelatinous left atrial myxoma

scholarly journals Fatal Paraneoplastic Embolisms in Both Circulations in a Patient with Poorly Differentiated Neuroendocrine Tumour

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
A. Busch ◽  
S. Tschernitz ◽  
A. Thurner ◽  
R. Kellersmann ◽  
U. Lorenz
Keyword(s):  
Lower Limb ◽  
Neuroendocrine Tumour ◽  
Limb Ischemia ◽  
Rapid Progress ◽  
Unique Case ◽  
Arterial Embolism ◽  
Unfractioned Heparin ◽  
Rare Manifestation ◽  
Poorly Differentiated ◽  
High Doses

Arterial embolism with lower limb ischemia is a rare manifestation of paraneoplastic hypercoagulability in cancer patients. We report a unique case of fatal thromboembolism involving both circulations associated with a poorly differentiated neuroendocrine tumor of the lung with rapid progress despite high doses of unfractioned heparin and review the current literature on anticoagulative regimen in tumour patients.

scholarly journals A COVID-19 patient with recurrent acute limb ischaemia despite two successive types of therapeutic dose anticoagulation and thrombolysis

2021 ◽  
Vol 14 (8) ◽  
pp. e245040
Author(s):  
Eva Teng ◽  
Marcelle Pignanelli ◽  
Faiza Hammad ◽  
David Wisa
Keyword(s):  
Lower Limb ◽  
Arterial Thrombosis ◽  
Distress Syndrome ◽  
Respiratory Illness ◽  
Limb Ischaemia ◽  
Heparin Infusion ◽  
Recurrent Ischaemia ◽  
Acute Limb Ischaemia ◽  
Upper Respiratory ◽  
Infusion Protocol

COVID-19 is caused by the SARS-CoV-2, and its presentation ranges from mild upper respiratory illness to critical disease including acute respiratory distress syndrome and multiorgan dysfunction. While it was initially believed to primarily target the respiratory system, numerous studies have demonstrated it to cause a hypercoagulable state that predisposes to arterial and venous thrombosis. We present a case where a patient with COVID-19 developed acute lower limb ischaemia due to arterial thrombosis in the setting of full-dose enoxaparin, followed by heparin infusion protocol. The patient developed recurrent ischaemia despite thrombolysis in addition to anticoagulation, and eventually required open thrombectomy before making a full recovery.

SARS-CoV-2 and COVID-19

2021 ◽  
Author(s):  
Rosalind Hollingsworth
Keyword(s):  
Distress Syndrome ◽  
Multiorgan Failure ◽  
Mainland China ◽  
Respiratory Illness ◽  
Infected Person ◽  
Increased Risk ◽  
Asymptomatic Infections ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome ◽  
Respiratory Droplets

Coronavirus disease 19 (COVID-19) is a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus which emerged in Wuhan, China in 2019, and from there spread to other parts of mainland China and around the world. The virus spreads mainly through respiratory droplets produced when an infected person coughs, sneezes, or speaks. On average, the time from exposure to SARS-CoV-2 to the appearance of symptoms is 5–6 days but can range from 1–14 days. Asymptomatic infections with SARS-CoV-2 can occur. In those with symptoms, most people (approx. 80%) will experience a mild to moderate respiratory illness and recover without hospital management. Adults 65 years of age and older, and individuals of any age with underlying medical conditions, are at increased risk for severe COVID-19 and death. Complications include respiratory failure, acute respiratory distress syndrome, sepsis/septic shock, thromboembolism, multiorgan failure and death. In rare cases, children and adults can develop a severe inflammatory syndrome a few weeks after SARS-COV-2 infection. Vaccines are available to help prevent COVID-19 disease; by August 2021, 7 vaccines had been authorized for use by the WHO to prevent COVID-19 caused by SARS-CoV-2, with others approved by country regulatory authorities.

scholarly journals A review of aortic thrombosis in COVID-19 infection

2021 ◽  
Author(s):  
Korin Karabulut ◽  
Ahmet Kapici ◽  
Ana Andronikashvili ◽  
James Morgan
Keyword(s):  
Wide Spectrum ◽  
Thrombotic Event ◽  
Clinical Manifestations ◽  
Limb Ischemia ◽  
Aortic Disease ◽  
High Morbidity ◽  
Acute Limb Ischemia ◽  
Aortic Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Aortic Thrombus

Aim: As the novel coronavirus disease 2019 (COVID-19) pandemic impacts the global healthcare system, evolving data show increased frequency of arterial and venous thromboembolism among patients with COVID-19 infection. Aortic thrombus is a rare thrombotic event with a wide spectrum of clinical manifestations and potential catastrophic complications. This study aimed to elucidate the clinical manifestations, diagnosis and treatment dilemmas of aortic thrombus with COVID-19 infection and raise awareness among frontline medical providers. Aortic thrombosis is rare, but if not considered early in the course of COVID-19 infection, the data suggest that the diagnosis will probably not be made until potentially serious complications arise. Methods: Literature review was conducted between November 1, 2019, and November 14, 2020, on PubMed and Embase to identify publications regarding aortic thrombosis among COVID-19 cases. Results: Most of the patients were male with a median age of 67 years, and had comorbidities (most commonly hypertension, dyslipidemia and diabetes mellitus). In our study, underlying atherosclerosis, a common risk factor for aortic thrombus, was identified among 56% of the patients. Aortic thrombus was symptomatic in 62% of these patients and most commonly manifested itself as acute limb ischemia (46%), whereas 30% of cases were found incidentally during the investigation of elevated inflammatory markers or increased oxygen requirement. Treatment was individualized given the lack of established guidelines for aortic thrombus, including anticoagulation, systemic and catheter directed thrombolysis, and surgical thrombectomy. Overall mortality was found to be 30% in our study. Conclusions: Although rare, aortic thrombus has high morbidity and mortality, and can present without any symptoms or underlying aortic disease. Aortic thrombosis is rare, but if not considered early in the course of COVID-19 infection, the data suggest that the diagnosis will probably not be made until potentially serious complications arise.

scholarly journals Efficiency of the Endovascular Correction of Clinically Evident Degrees of Chronic Obliterating Lower Limb Diseases in Multisegment Lesions

2020 ◽  
pp. 14-20
Author(s):  
S. Yu. Gorokhovsky ◽  
A. A. Lyzikov ◽  
M. L. Kaplan ◽  
V. E. Tihmanovich
Keyword(s):  
Lower Limb ◽  
Surgical Intervention ◽  
Ankle Brachial Index ◽  
Clinical Manifestations ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Treatment Results ◽  
Arterial Lesion ◽  
Arterial Lesions ◽  
Arterial Insufficiency

Objective: to evaluate the efficiency and extent of endovascular revascularization in patients with multisegment lesions in chronic obliterating diseases of the lower limb arteries.Material and methods. The outcomes of the endovascular correction of multisegment lesions of the lower limb arteries were analyzed in 10 patients. Results. After the treatment the patients revealed a statistically significant change (increase of the value) of the ankle-brachial index (ABI) (p = 0.001). The ABI value after the surgical intervention amounted to 0.81 (0.71; 0.87), which was connected with a favourable prognosis for such patients. Аccording to the established criteria, the outcomes of the interventions comprised the decrease of the degree of chronic arterial insufficiency (p < 0.01), all the patients were discharged having no clinical manifestations of critical lower limb ischemia or decreased evidence of intermittent claudication.Conclusion. The majority of patients with clinically evident ischemia of the lower limbs suffer from multisegment arterial lesion (the number of the segments exceeds 2), which entails the need of multiple corrections in one patient. Meanwhile, the evaluation of the treatment results is possible only in the postoperative period according to the indirect criteria. Therefore, during the operation there arises the need to develop a method of the objective intraoperative evaluation of the extent and efficiency of the performed correction of arterial lesions on each segment.

scholarly journals Concomitant Acute Limb Ischemia and Pulmonary Embolism in the Course of SARS-CoV-2 Infection: Case Report

2021 ◽  
Vol 6 (11) ◽  
pp. 831-834
Author(s):  
Mahassine El Harras ◽  
Amal Elouarradi ◽  
Salma Abdeladim ◽  
Fatimazahra Merzouk ◽  
Meryem Kassimi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Significant Morbidity ◽  
Mild Form ◽  
Case Presentation ◽  
Disease Case ◽  
Thrombotic Complications ◽  
Prophylactic Anticoagulation

Background: The new 2019 coronavirus disease (COVID-19) is associated with significant morbidity and mortality. Thrombotic complications are increasingly recognized as an important part of this disease. Thromboprophylaxis with anti-platelet drugs and anticoagulants are recommended in the initial treatment of the disease. Case presentation: We report the case of a patient hospitalized for a mild form of COVID19 pneumonia, who was admitted, one month later, acute limb ischemia and pulmonary embolism despite antithrombotic prophylaxis. Conclusion: Most reported cases are either arterial or venous thrombosis. The concomitant combination of arterial and venous thrombosis is rarely reported. The prophylactic anticoagulation strategy in the SARS- Cov 2 infection is still not well established.

scholarly journals Acute Aortic Occlusion with Acute Onset of Paraplegia and Severe Hyposthenia

2020 ◽  
pp. 1-3
Author(s):  
Stefania Tamburrini ◽  
Daniela Viola ◽  
Fabio Spinetti ◽  
Giuseppe Mercogliano ◽  
Giuseppe Sarti ◽  
...  
Keyword(s):  
Lower Limb ◽  
Mesenteric Artery ◽  
Limb Ischemia ◽  
Acute Onset ◽  
Lower Limbs ◽  
Motor Deficit ◽  
Acute Limb Ischemia ◽  
Neurological Assessment ◽  
Bilateral Lower Limb ◽  
Acute Aortic Occlusion

A 75-years-old man presented at our ED with acute onset of paraplegia and severe bilateral lower limb hyposthenia. The patient ‘s neurological assessment was negative except for lower limbs positive Mingazzini test. CT angiography detected a complete lack of opacification of the abdominal aorta immediately below the emergency of the inferior mesenteric artery, caused by a coarse thrombus in the left ventricle. We present a case of acute aortic and lumbar arteries thrombosis with paraplegia and no clear symptoms of acute limb ischemia, in which the motor deficit in the lower extremities was explained by anterior spinal cord syndrome secondary to acute occlusion of lumbar arteries.

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