Thrombosis of the right iliac, femoral, popliteal, and tibial arteries in a post-COVID-19 in adolescent

• Published in: Annals of Pediatric Surgery Vol. 17; no. 1; p. 57
• Main Authors: da Silva, Mariana Orate Menezes, Amorim Santos, Henrique, da Silva, Amanda Fernandes Vidal, Marum, Guilherme, de Godoy, Jose Maria Pereira
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 07.09.2021; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Anticoagulants; Arteries; Blood clot; Case Reports; Coronaviruses; COVID-19; Femoral; Iliac; Infection; Medicine; Medicine & Public Health; Multisystem inflammatory syndrome in children; Pediatrics; Popliteal; Teenagers; Thrombosis; Tibial; Veins & arteries; United States > US; COVID-19; Popliteal; Adolescent; Tibial; Thrombosis; Femoral; Arteries; Iliac
• ISSN: 2090-5394; 1687-4137; 2090-5394
• DOI: 10.1186/s43159-021-00124-5

Background Viral infection into lung, muscular, and endothelial cells results in inflammatory response, including edema, degeneration, and necrotic alterations. The involvement of the major arteries in adolescent with COVID-19 has been infrequently reported in the literature. The aim of the present study is to report thrombosis of the right iliac, femoral and tibial arteries and stenosis of left iliac artery in an adolescent with COVID-19 and to discuss the pathophysiological hypotheses. Case presentation We report the case of a 17-year-old female patient with COVID-19 infection. She was seen at the physician specialized general medicine in her hometown, was diagnosed with COVID-19 but did not require hospitalization. After 15 days, she had sudden pain in the left leg that has limited her ability to walk more than 10 met, associated with extremity cyanosis and coldness. Angiotomography revealed thrombosis of a portion of the iliac and popliteal arteries. Na emergency embolectomy was successfully performed, followed by full-dose heparinization with unfractionated heparin. Conclusion Arterial thrombosis of large arteries may be associated with chronic inflammatory syndrome secondary to COVID-19 infection and the treatment with a late embolectomy was successful, even in a thrombotic event.