Single-Center Experience with Simultaneous Mural Aortic Thrombosis and Peripheral Obstructive Disease in Pre-COVID-19 and COVID-19 Era
Background: Mural aortic thrombosis associated with chronic peripheral obstruction of the lower limbs is an unusual event. Repeated embolism of instability aortic mural thrombosis caused acute limb ischemia (Rutherford 2 classification) in patients with peripheral arterial disease (PAD). We report a...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/6/1208 |
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| author | Filippo Benedetto Francesco La Corte Domenico Spinelli Gabriele Piffaretti Santi Trimarchi Giovanni De Caridi |
| author_facet | Filippo Benedetto Francesco La Corte Domenico Spinelli Gabriele Piffaretti Santi Trimarchi Giovanni De Caridi |
| author_sort | Filippo Benedetto |
| collection | DOAJ |
| description | Background: Mural aortic thrombosis associated with chronic peripheral obstruction of the lower limbs is an unusual event. Repeated embolism of instability aortic mural thrombosis caused acute limb ischemia (Rutherford 2 classification) in patients with peripheral arterial disease (PAD). We report a single-center experience for patients with transmural aortic thrombosis and peripheral artery disease. Methods: We retrospectively analyzed data of 54 patients with aortic mural thrombus disease with PAD presentation, treated at our center between 2013 and 2022. Results: Thirty patients (six with proven SARS-CoV-2 infection) underwent hybrid or staged treatment for an aortic lesion and for lower limb ischemia, by the placement of an endovascular aortic stent graft and a femoro-distal or a popliteal-distal bypass graft. The remaining 24 cases were only subjected to an intravascular treatment of the thoracic or abdominal aorta. Transient renal failure occurred in three patients. No embolic events were detected during the procedures. Aortic-related mortality was reported in just one patient who died from multiple organ failure. There was an embolic stroke in one patient with proven SARS-CoV-2 infection, three major amputations in patients with proven SARS-CoV-2 infection and no aortic-related mortality. Conclusions: Stent coverage of complex aortic lesions, alone or in association with a distal bypass graft, supports this approach in a variety of settings. The COVID-19 pandemic caused an increased mortality and amputation rate. |
| first_indexed | 2024-03-11T06:40:53Z |
| format | Article |
| id | doaj.art-77a9cbbac5294e318fb180872d6f8938 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T06:40:53Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-77a9cbbac5294e318fb180872d6f89382023-11-17T10:35:50ZengMDPI AGDiagnostics2075-44182023-03-01136120810.3390/diagnostics13061208Single-Center Experience with Simultaneous Mural Aortic Thrombosis and Peripheral Obstructive Disease in Pre-COVID-19 and COVID-19 EraFilippo Benedetto0Francesco La Corte1Domenico Spinelli2Gabriele Piffaretti3Santi Trimarchi4Giovanni De Caridi5Department of Biomedical Sciences and of Morphological and Functional Image, University of Messina, 98100 Messina, ItalyDepartment of Biomedical Sciences and of Morphological and Functional Image, University of Messina, 98100 Messina, ItalyDepartment of Biomedical Sciences and of Morphological and Functional Image, University of Messina, 98100 Messina, ItalyDepartment of Medicine and Surgery, School of Medicine, Varese University Hospital, University of Insubria, 21100 Varese, ItalyDepartment of Clinical Sciences and Community Health, University of Milano, 20122 Milan, ItalyDepartment of Biomedical Sciences and of Morphological and Functional Image, University of Messina, 98100 Messina, ItalyBackground: Mural aortic thrombosis associated with chronic peripheral obstruction of the lower limbs is an unusual event. Repeated embolism of instability aortic mural thrombosis caused acute limb ischemia (Rutherford 2 classification) in patients with peripheral arterial disease (PAD). We report a single-center experience for patients with transmural aortic thrombosis and peripheral artery disease. Methods: We retrospectively analyzed data of 54 patients with aortic mural thrombus disease with PAD presentation, treated at our center between 2013 and 2022. Results: Thirty patients (six with proven SARS-CoV-2 infection) underwent hybrid or staged treatment for an aortic lesion and for lower limb ischemia, by the placement of an endovascular aortic stent graft and a femoro-distal or a popliteal-distal bypass graft. The remaining 24 cases were only subjected to an intravascular treatment of the thoracic or abdominal aorta. Transient renal failure occurred in three patients. No embolic events were detected during the procedures. Aortic-related mortality was reported in just one patient who died from multiple organ failure. There was an embolic stroke in one patient with proven SARS-CoV-2 infection, three major amputations in patients with proven SARS-CoV-2 infection and no aortic-related mortality. Conclusions: Stent coverage of complex aortic lesions, alone or in association with a distal bypass graft, supports this approach in a variety of settings. The COVID-19 pandemic caused an increased mortality and amputation rate.https://www.mdpi.com/2075-4418/13/6/1208aortic thrombosisperipheral artery diseasefollow-upCOVID-19 |
| spellingShingle | Filippo Benedetto Francesco La Corte Domenico Spinelli Gabriele Piffaretti Santi Trimarchi Giovanni De Caridi Single-Center Experience with Simultaneous Mural Aortic Thrombosis and Peripheral Obstructive Disease in Pre-COVID-19 and COVID-19 Era Diagnostics aortic thrombosis peripheral artery disease follow-up COVID-19 |
| title | Single-Center Experience with Simultaneous Mural Aortic Thrombosis and Peripheral Obstructive Disease in Pre-COVID-19 and COVID-19 Era |
| title_full | Single-Center Experience with Simultaneous Mural Aortic Thrombosis and Peripheral Obstructive Disease in Pre-COVID-19 and COVID-19 Era |
| title_fullStr | Single-Center Experience with Simultaneous Mural Aortic Thrombosis and Peripheral Obstructive Disease in Pre-COVID-19 and COVID-19 Era |
| title_full_unstemmed | Single-Center Experience with Simultaneous Mural Aortic Thrombosis and Peripheral Obstructive Disease in Pre-COVID-19 and COVID-19 Era |
| title_short | Single-Center Experience with Simultaneous Mural Aortic Thrombosis and Peripheral Obstructive Disease in Pre-COVID-19 and COVID-19 Era |
| title_sort | single center experience with simultaneous mural aortic thrombosis and peripheral obstructive disease in pre covid 19 and covid 19 era |
| topic | aortic thrombosis peripheral artery disease follow-up COVID-19 |
| url | https://www.mdpi.com/2075-4418/13/6/1208 |
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