Aortic thrombosis as a dramatic vascular complication in COVID-19 disease

• Published in: Journal de médecine vasculaire Vol. 47; no. 4; pp. 169 - 174
• Main Authors: Caudron, Charlotte, Ben Abdallah, Iannis, Détriché, Grégoire, Cherkaoui, Rita, Julia, Pierre, Alsac, Jean-Marc, Mirault, Tristan, El Batti, Salma
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.10.2022
• Subjects: Acute aortic thrombosis; Aged; Aortic Diseases - diagnostic imaging; Aortic Diseases - etiology; Aortic Diseases - surgery; Arterial Occlusive Diseases - surgery; Arterial thrombosis; COVID-19 - complications; COVID-19 disease; Humans; Male; Middle Aged; Mortality; Original; Retrospective Studies; Thrombosis - diagnostic imaging; Thrombosis - etiology; Thrombosis - therapy; Vascular complication; Arterial thrombosis; COVID-19 disease; Vascular complication; Mortality; Acute aortic thrombosis
• ISSN: 2542-4513; 2542-4513
• DOI: 10.1016/j.jdmv.2022.10.003

•AAT is a devastating complication of COVID-19 infection, and occurs in patients with cardiovascular risk factors.•The overall mortality rate and the amputation rate at 30 days are 30% in this cohort.•AAT is an early complication of COVID-19 infection, and when it occurs consequences are dramatic (bowel disruption, amputation, death). To report clinical outcomes of COVID-19 related acute aortic thrombosis (AAT). Consecutive COVID-19 patients presenting with AAT between April 2020 and August 2021 were included retrospectively. Clinical and radiological data were prospectively collected. Ten patients (men, 90%; mean age, 64 ± 2 years) were included. At the time of AAT diagnosis, four patients were in intensive care unit. Median time between diagnosis of COVID-19 and AAT was 5 days [IQR 0–8.5]. Clinical presentation was acute lower limb ischaemia (n=9) and mesenteric ischaemia (n=2). Thrombus localization was the abdominal aorta (n=5), the thoracic aorta (n=2) or both (n=3), with the following embolic sites: lower limbs (n=9), renal arteries (n=3), superior mesenteric artery (n=2), splenic artery (n=1), cerebral arteries (n=1). Revascularization was performed in 9 patients, using open (n=6), endovascular (n=2) or hybrid techniques (n=1). Three patients required reinterventions. The 30-day mortality was 30%. Three major amputations were performed in two patients, resulting in a free-amputation survival rate of 50% after a median follow-up of 3,5 months [IQR 2–4.1]. AAT is a rare and devastating complication of COVID-19 disease, responsible for high mortality and amputation rates.