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Angiología
versão On-line ISSN 1695-2987versão impressa ISSN 0003-3170
Resumo
CUBAS, Wildor Samir; ROJAS-HUILLCA, Miguel e SALAZAR-CUIZANO, Milagros. Acute lower limb arterial thrombosis in COVID-19 infected patients: experience in a national hospital in Peru. Angiología [online]. 2023, vol.75, n.3, pp.136-145. Epub 24-Jul-2023. ISSN 1695-2987. https://dx.doi.org/10.20960/angiologia.00459.
Introduction and objective:
the COVID-19 pandemic has been associated with a series of clinical vascular conditions of the Acute Arterial Thrombosis of the Lower Limbs (AATLL) type and which have been associated with high morbidity and mortality and loss of the affected limb. The objective of the study was to describe the clinical-surgical characteristics of patients infected with COVID-19 and TAAMI in a national hospital in Peru.
Methods:
observational, descriptive; and retrospective study carried out at the Edgardo Rebagliati Martins National Hospital from March 2020-February 2022. The main variables considered were the clinical stage of COVID-19, laboratory tests, grade, time and location of the TAAMI, treatment, type of amputation, mortality; and 30-day survival.
Results:
96 patients (mean age, 62.9 years) mainly male (61.45 %) were analyzed; and the main comorbidity was diabetes (54.16 %). The mean TAAMI time was 11.5 hours, and 25 % of all patients presented severe COVID-19 infection. The main Rutherford Score was IIB (32.29 %) and the main affected arteries belonged to the femoro-popliteal segment (superficial femoral, 41.81 %) and infra-popliteal (anterior tibial, 39.67 %). Thromboembolectomy (60.41 %) was the main surgical treatment and 55.17 % of the patients ended in amputation. Survival and mortality at 30 days were 46.8 % and 53.2 %, respectively. The main causes of mortality were severe respiratory distress (69.41 %) and septic shock (22.94 %).
Conclusions:
early diagnosis and timely management of TAAMI determines an important factor for the patient's prognosis; however, the associated comorbidities, severity of the COVID-19 infection, prolonged times of ischemia, superimposed infection and related hyperinflammatory states, end up directing the patient's destiny towards a series of complications that include amputation, functional limitation and associated mortality.
Palavras-chave : Acute arterial thrombosis; COVID-19; Lower limbs; Morbidity and mortality.