Acute aortoiliac occlusion in a patient with novel coronavirus disease-2019

Abstract

The severe acute respiratory syndrome novel coronavirus-2 pandemic is affecting almost every country in the world. Even if the major symptoms of coronavirus disease-2019 are respiratory, different symptoms at presentation are now recognized. Venous thromboembolism has been reported in infected patients and few but increasing cases of arterial thrombosis have been described. We report a case of acute aortoiliac and lower limb artery occlusions in a patient presenting with severe coronavirus disease-2019 infection. The mechanism of the occlusion seemed to be distal embolization from a floating thrombus in the aortic arch caused by a major inflammatory state and virus infection. The patient underwent aortoiliac and lower limb artery mechanical thrombectomy, but required unilateral major amputation.

Keywords: Arterial occlusion; Arterial thrombosis; COVID-19; Coronavirus; Inflammatory state.

Fig 1

Infrarenal distal aortic and left iliac artery thrombotic occlusion on preoperative computed tomography (CT) scan (white arrows).

Fig 2

Aortic arch thrombus (black and white arrows).

Fig 3

Thoracic preoperative computed tomography (CT) scan showing pulmonary lesions typical of coronavirus disease-2019 (COVID-19).

Fig 4

Thrombus extracted from the iliac and popliteal left arteries.