An extensive arterial thrombosis with lower limb ischemia in a COVID‐19 patient: A case report
Key Clinical Message The coronavirus disease 2019 (COVID‐19) pandemic is responsible for huge morbidity and mortality throughout the world. Several serious complications of this disease have been reported. It can cause hypercoagulability, which may lead to venous and arterial thromboembolic diseases...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.8231 |
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| author | Johary Andriamamonjisoa Andriamizanaka Etienne Rakotomijoro Volatiana Andriananja Mihaja Raberahona Radonirina Lazasoa Andrianasolo Rivonirina Andry Rakotoarivelo Jean deDieu Randria Mamy |
| author_facet | Johary Andriamamonjisoa Andriamizanaka Etienne Rakotomijoro Volatiana Andriananja Mihaja Raberahona Radonirina Lazasoa Andrianasolo Rivonirina Andry Rakotoarivelo Jean deDieu Randria Mamy |
| author_sort | Johary Andriamamonjisoa Andriamizanaka |
| collection | DOAJ |
| description | Key Clinical Message The coronavirus disease 2019 (COVID‐19) pandemic is responsible for huge morbidity and mortality throughout the world. Several serious complications of this disease have been reported. It can cause hypercoagulability, which may lead to venous and arterial thromboembolic diseases. This hypercoagulability state is also associated with high morbidity and mortality. Arterial thrombosis in COVID‐19 is poorly described compared to venous thrombosis and pulmonary embolism. We report a case of an extensive arterial thrombosis leading to a limb ischemia with extremely high D‐dimer in a COVID‐19 patient. A 69‐year‐old man was hospitalized for febrile dyspnea. He is a hypertensive and diabetic patient. On admission, pulse oxygen saturation was 72% on room air. He had cyanosis of the left foot up to the mid‐thigh. The left pedal, posterior tibial, popliteal and femoral pulses were abolished. Chest CT scan was in favor of COVID‐19. He has a high D‐dimer level of 257,344 ng/mL. Arterial Echo‐Doppler found an extensive intraluminal thrombus along the arterial axes of the left lower limb, completely obstructing them, starting from the primitive iliac artery just after its bifurcation with the aorta, and extending distally (external iliac; common femoral; superficial femoral; popliteal; anterior tibial; posterior tibial; fibular and pedal). The patient was diagnosed with COVID‐19 critical form, associated with ischemia of the left lower limb secondary to an extensive arterial thrombosis. He was receiving anticoagulation, and underwent surgical amputation of the ischemic limb. The patient survived the event; however, he was on long‐term oxygen therapy at home. Arterial thrombosis may occur during COVID‐19 and may be responsible for peripheral or central ischemia aggravating morbidity and mortality. The occurrence of these events is related to the D‐dimer value. Anticoagulation is an important part of the management of COVID‐19, especially in severe forms in order to limit the occurrence of these thromboembolic diseases. |
| first_indexed | 2024-03-09T14:29:22Z |
| format | Article |
| id | doaj.art-03dd0284c22e49699150f09bfe3dcce9 |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-03-09T14:29:22Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-03dd0284c22e49699150f09bfe3dcce92023-11-28T04:14:45ZengWileyClinical Case Reports2050-09042023-11-011111n/an/a10.1002/ccr3.8231An extensive arterial thrombosis with lower limb ischemia in a COVID‐19 patient: A case reportJohary Andriamamonjisoa Andriamizanaka0Etienne Rakotomijoro1Volatiana Andriananja2Mihaja Raberahona3Radonirina Lazasoa Andrianasolo4Rivonirina Andry Rakotoarivelo5Jean deDieu Randria Mamy6Department of Infectious Diseases, Faculty of Medicine University of Antananarivo, Joseph Raseta Befelatanana University Hospital Antananarivo Antananarivo MadagascarDepartment of Infectious Diseases, Faculty of Medicine University of Antananarivo, Joseph Raseta Befelatanana University Hospital Antananarivo Antananarivo MadagascarDepartment of Infectious Diseases, Faculty of Medicine University of Antananarivo, Joseph Raseta Befelatanana University Hospital Antananarivo Antananarivo MadagascarDepartment of Infectious Diseases, Faculty of Medicine University of Antananarivo, Joseph Raseta Befelatanana University Hospital Antananarivo Antananarivo MadagascarDepartment of Endocrinology, Faculty of Medicine University of Antananarivo, Joseph Raseta Befelatanana University Hospital Antananarivo Antananarivo MadagascarDepartment of Infectious Diseases, Faculty of Medicine University of Fianarantsoa, University Hospital Tambohobe Fianarantsoa Fianarantsoa MadagascarDepartment of Infectious Diseases, Faculty of Medicine University of Antananarivo, Joseph Raseta Befelatanana University Hospital Antananarivo Antananarivo MadagascarKey Clinical Message The coronavirus disease 2019 (COVID‐19) pandemic is responsible for huge morbidity and mortality throughout the world. Several serious complications of this disease have been reported. It can cause hypercoagulability, which may lead to venous and arterial thromboembolic diseases. This hypercoagulability state is also associated with high morbidity and mortality. Arterial thrombosis in COVID‐19 is poorly described compared to venous thrombosis and pulmonary embolism. We report a case of an extensive arterial thrombosis leading to a limb ischemia with extremely high D‐dimer in a COVID‐19 patient. A 69‐year‐old man was hospitalized for febrile dyspnea. He is a hypertensive and diabetic patient. On admission, pulse oxygen saturation was 72% on room air. He had cyanosis of the left foot up to the mid‐thigh. The left pedal, posterior tibial, popliteal and femoral pulses were abolished. Chest CT scan was in favor of COVID‐19. He has a high D‐dimer level of 257,344 ng/mL. Arterial Echo‐Doppler found an extensive intraluminal thrombus along the arterial axes of the left lower limb, completely obstructing them, starting from the primitive iliac artery just after its bifurcation with the aorta, and extending distally (external iliac; common femoral; superficial femoral; popliteal; anterior tibial; posterior tibial; fibular and pedal). The patient was diagnosed with COVID‐19 critical form, associated with ischemia of the left lower limb secondary to an extensive arterial thrombosis. He was receiving anticoagulation, and underwent surgical amputation of the ischemic limb. The patient survived the event; however, he was on long‐term oxygen therapy at home. Arterial thrombosis may occur during COVID‐19 and may be responsible for peripheral or central ischemia aggravating morbidity and mortality. The occurrence of these events is related to the D‐dimer value. Anticoagulation is an important part of the management of COVID‐19, especially in severe forms in order to limit the occurrence of these thromboembolic diseases.https://doi.org/10.1002/ccr3.8231arterial thrombosiscase reportCOVID‐19D‐dimerischemia |
| spellingShingle | Johary Andriamamonjisoa Andriamizanaka Etienne Rakotomijoro Volatiana Andriananja Mihaja Raberahona Radonirina Lazasoa Andrianasolo Rivonirina Andry Rakotoarivelo Jean deDieu Randria Mamy An extensive arterial thrombosis with lower limb ischemia in a COVID‐19 patient: A case report Clinical Case Reports arterial thrombosis case report COVID‐19 D‐dimer ischemia |
| title | An extensive arterial thrombosis with lower limb ischemia in a COVID‐19 patient: A case report |
| title_full | An extensive arterial thrombosis with lower limb ischemia in a COVID‐19 patient: A case report |
| title_fullStr | An extensive arterial thrombosis with lower limb ischemia in a COVID‐19 patient: A case report |
| title_full_unstemmed | An extensive arterial thrombosis with lower limb ischemia in a COVID‐19 patient: A case report |
| title_short | An extensive arterial thrombosis with lower limb ischemia in a COVID‐19 patient: A case report |
| title_sort | extensive arterial thrombosis with lower limb ischemia in a covid 19 patient a case report |
| topic | arterial thrombosis case report COVID‐19 D‐dimer ischemia |
| url | https://doi.org/10.1002/ccr3.8231 |
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