Indian Journal of Vascular and Endovascular Surgery (Jan 2022)

Clinical Profile and Outcomes in Surgically Treated COVID-19 Patients Presenting with Acute Limb Ischemia

  • Jayesh Patel,
  • Varin Rangwala,
  • Zeel Thakkar,
  • Ravi Bhatt

DOI
https://doi.org/10.4103/ijves.ijves_137_21
Journal volume & issue
Vol. 9, no. 2
pp. 178 – 180

Abstract

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Background: Acute limb ischemia (ALI) refers to a sudden decrease in blood flow to the limb which threatens its viability. Such a sudden event of decreased or absent arterial supply to the limb causes ischemia and poor perfusion outcomes. The most common causes of ALI include embolism and thrombosis. Others include acute on chronic peripheral arterial occlusive disease or major trauma. It is well known to us that COVID-19 is a hypercoagulable state. In this prothrombotic state, patients can also present with ALI, with clinical features of pain, paresthesia, pulselessness, pallor, poikilothermia, and paralysis of the affected limb. Such patients rapidly progress to severe stages of limb ischemia that need immediate treatment to save the limb. Thus, our study aims to revisit the clinical features and outcomes of procedures performed on such patients. Materials and Methods: This is a single-center, retrospective study. COVID patients with ALI who underwent any surgical procedure, from February 2021 to July 2021, were identified from the surgical operation theater's list of the hospital. Detailed information regarding these patients was obtained from the digital software of the hospital. Detailed computed tomography angiography findings were also obtained from the radiology department. A required statistical study was done. Results: Nineteen COVID patients presenting with ALI and requiring surgical treatment were identified during the study period of 6 months. A complete study of their clinical presentations, surgical procedures performed and the outcomes, is done. The study shows that the most common site affected was the lower limb (95%) with occlusion occurring mainly in the popliteal artery, i.e., the lower limb artery. Conclusion: Recognition of limb ischemia at an early stage, considering it as a symptom or complication of COVID-19, may allow for early and prompt diagnosis and treatment of this condition.

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