Abstract:
BACKGROUND:Coronavirus disease 2019 (COVID-19) predisposes to arterial and venous thromboembolic complications. We describe the clinical presentation, management, and outcomes of acute arterial ischemia and concomitant infection at the epicenter of cases in the United States. METHODS:Patients with confirmed COVID-19 infection between March 1, 2020 and May 15, 2020 with an acute arterial thromboembolic event were reviewed. Data collected included demographics, anatomical location of the thromboembolism, treatments, and outcomes. RESULTS:Over the 11-week period, the Northwell Health System cared for 12,630 hospitalized patients with COVID-19. A total of 49 patients with arterial thromboembolism and confirmed COVID-19 were identified. The median age was 67 years (58-75) and 37 (76%) were men. The most common preexisting conditions were hypertension (53%) and diabetes (35%). The median D-dimer level was 2,673 ng/mL (723-7,139). The distribution of thromboembolic events included upper 7 (14%) and lower 35 (71%) extremity ischemia, bowel ischemia 2 (4%), and cerebral ischemia 5 (10%). Six patients (12%) had thrombus in multiple locations. Concomitant deep vein thrombosis was found in 8 patients (16%). Twenty-two (45%) patients presented with signs of acute arterial ischemia and were subsequently diagnosed with COVID-19. The remaining 27 (55%) developed ischemia during hospitalization. Revascularization was performed in 13 (27%) patients, primary amputation in 5 (10%), administration of systemic tissue- plasminogen activator in 3 (6%), and 28 (57%) were treated with systemic anticoagulation only. The rate of limb loss was 18%. Twenty-one patients (46%) died in the hospital. Twenty-five (51%) were successfully discharged, and 3 patients are still in the hospital. CONCLUSIONS:While the mechanism of thromboembolic events in patients with COVID-19 remains unclear, the occurrence of such complication is associated with acute arterial ischemia which results in a high limb loss and mortality.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Etkin Y,Conway AM,Silpe J,Qato K,Carroccio A,Manvar-Singh P,Giangola G,Deitch JS,Davila-Santini L,Schor JA,Singh K,Mussa FF,Landis GSdoi
10.1016/j.avsg.2020.08.085subject
Has Abstractpub_date
2021-01-01 00:00:00pages
290-294eissn
0890-5096issn
1615-5947pii
S0890-5096(20)30765-2journal_volume
70pub_type
杂志文章abstract:BACKGROUND:The D-dimer (DD) level combined with the pretest Wells criteria probability (WCP) score can safely exclude deep venous thrombosis (DVT). The objective of this study was to examine the correlation between DD results alongside WCP score with findings on venous duplex ultrasound (VDU). The hypothesis is that VD...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.12.006
更新日期:2018-07-01 00:00:00
abstract::Resection of carotid body tumors (neck paragangliomas) carries inherent risks of injury to the cranial nerves and other structures as well excessive blood loss. Preoperative embolization has been used to lessen the morbidity in tumors that are larger than 2 cm in diameter. Two female patients presented for treatment w...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010058
更新日期:2001-03-01 00:00:00
abstract::OMNEX (Ethicon, Inc.; Somerville, NJ) is a cyanoacrylate-based synthetic surgical sealant. To date, the use of OMNEX has only been described in a limited number of vascular surgery procedures. We present the cases of two patients who underwent successful extracorporeal renal artery aneurysm repair with the aid of OMNE...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.07.009
更新日期:2011-11-01 00:00:00
abstract::Venous thoracic outlet syndrome (V-TOS) and associated subclavian vein thrombosis (SVT) result in significant patient morbidity and can be difficult to manage. Previous studies have suggested that both mechanical compressive factors and pathological alterations in patient coagulation may contribute to the development ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9106-z
更新日期:2006-09-01 00:00:00
abstract::The treatment for obturator bypass graft infection has been rarely reported and is a surgical challenge because it is difficult to debride infected tissue around the graft located in the deep route and to ensure an alternative revascularization route in patients with a history of inguinal infection. Percutaneous conti...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.04.039
更新日期:2019-11-01 00:00:00
abstract::Acute spontaneous and isolated dissection of the iliofemoral artery is an extremely rare entity. Conservative, surgical, and endovascular treatment have been used to treat such cases. To the best of our knowledge we report the first case of using hybrid management to successfully treat isolated external iliac artery d...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.04.018
更新日期:2014-02-01 00:00:00
abstract::Neuropeptide Y (NPY) is a potent vasoconstrictive polypeptide colocalized with norepinephrine in sympathetic neurons. The effects of ischemia and reperfusion on plasma NPY levels were studied and compared in the mongrel dog after infrarenal aortic cross-clamping. We found a two- to threefold increase in NPY levels dur...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02132996
更新日期:1994-07-01 00:00:00
abstract::Synovial hemangioma is a rare benign vascular malformation. We report a case of chronic swelling in the left knee of a 7-year-old boy. An intra-articular tumor of synovial origin could was detected after a magnetic resonance imaging scan. Surgical excision of the mass associated with partial synovectomy was carried ou...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.08.019
更新日期:2014-01-01 00:00:00
abstract::Pseudoaneurysm of the internal mammary artery is an unusual complication of wounds to the chest. We report a case of a 41-year-old man who sustained a stab chest wound and posttraumatic pseudoaneurysm of the internal mammary artery, resulting in hemomediastinum and hemothorax. The patient was successfully treated usin...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.06.034
更新日期:2014-04-01 00:00:00
abstract::Post-thrombotic reflux in deep veins of the lower extremities cannot be treated by in situ valvuloplasty because of valve degeneration. The outcome of transplantation and transposition of segments with valves is controversial. From feasibility tests in animals and fresh human cadavers we have developed an autogenous v...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900267
更新日期:1999-05-01 00:00:00
abstract::We report the case of a 36-year-old male, admitted in the emergency room with a nonruptured brachial pseudoaneurysm after buprenorphine injection, with no signs of distal acute ischemia. After endovascular treatment with a nitinol covered stent associated with adapted antibiotherapy and 35 days of hospitalizations, th...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.061
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:An aggressive surgical approach to locally advanced malignancy is being increasingly used in the absence of distant metastatic disease. This includes resection and reconstruction of major venous structures. We investigated the results of using a multidisciplinary surgical approach in these instances. METHOD...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.01.012
更新日期:2015-07-01 00:00:00
abstract::Ischemia occurring during hyperextension of the upper limb in a 25-year-old woman led to the discovery of a supracondylar spur responsible for compression of the brachial artery with anomalous insertion of the pronator teres muscle. Resection of all abnormal structures provided immediate relief of symptoms. When atypi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60736-X
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:We aimed to investigate whether the transfusion of 2 units of fresh frozen plasma (FFP) immediately post aneurysm exclusion has any effect on the perioperative fibrinogen levels and the outcome of patients undergoing elective endovascular repair (EVAR) of abdominal aortic aneurysm (AAA). METHODS:Consecutive...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.09.003
更新日期:2020-09-16 00:00:00
abstract::From 1981 to 1995 a total of 14 patients with a mean age of 52 years (range: 23-71) underwent surgery for 15 aneurysms of the extracranial internal carotid artery. Fusiform aneurysms of the carotid bifurcation were not included in this study. Aneurysm led to brain ischemia in 10 cases and rupture in one case. In the r...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900079
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Off-label parallel endografting (PE) has been increasingly criticized in favor of on-label custom fenestrated endografts. There remain limited direct comparisons, however, between concurrent patient populations treated by similarly experienced operators. Hence, we seek to evaluate the relative efficacy of th...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.09.009
更新日期:2017-01-01 00:00:00
abstract::Central venous pressure (CVP) has long been thought to correlate with cerebrospinal fluid (CSF) pressure during thoracoabdominal aortic aneurysm repair. We examined hemodynamic factors during thoracoabdominal aortic aneurysm surgery to determine their relationship with CSF pressure and aortic cross-clamping. Hemodynam...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-005-5017-7
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:The incidence of localized popliteal disease is rare. Currently, patients presenting with symptomatic popliteal disease are offered femoropopliteal or tibial bypass if the disease is not amenable to radiologic intervention. We feel that popliteal endarterectomy by means of a posterior approach with patch ang...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.09.005
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Medical care in the United States has evolved into a more cost-conscious value-based health care system that necessitates a comparison of costs when there are alternative interventions considered to be acceptable in the treatment of a disease. This study compares the cost differences between regional anesthe...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.05.124
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine early and mid-term outcomes after open repair of thoracoabdominal aortic aneurysm, with moderate to deep hypothermia as part of proximal aortic management. METHODS:Between April 2009 and March 2015, 44 patients underwent thoracoabdominal aortic repair by total cardiopu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.08.021
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:We report endovascular treatment of a patient with an isolated Internal Iliac Artery (IIA) aneurysm who was treated by positioning a novel covered stent that could adapt to different proximal and distal diameters. CASE REPORT:A 68-year-old man who had already had several previous aortic surgeries underwent ...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.10.059
更新日期:2020-04-01 00:00:00
abstract::We report a case of a 55-year-old woman who was referred to us with a huge chronic postdissection thoracoabdominal aneurysm of a maximal intrathoracic diameter of 13.5 cm and signs of intrathoracic imminent rupture with subparietal pleural hemorrhagic effusion. Computed tomography examination revealed that the left lu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.02.049
更新日期:2012-02-01 00:00:00
abstract::Twenty-nine cases of post-traumatic false aneurysms and arteriovenous fistulas (AVF), with a mean follow-up of 24 months (1-65 months), are presented here. Diagnosis was established by color duplex and arteriogram. The time between injury and treatment varied between 3 days and 61 months. Endovascular treatment was ac...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900230
更新日期:1999-03-01 00:00:00
abstract::Variations of hepatic vascular system have been more important with improvements in some clinical procedures such as hepatic transplantation or radiologic chemoembolization of hepatic tumors. Multidetector computed tomography is a useful noninvasive imaging tool for differentiating such variations. ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.12.010
更新日期:2015-01-01 00:00:00
abstract::Duplex scanning used to determine graft flow velocities is an effective means of identifying lower extremity bypass grafts at risk for failure before they occlude. We implemented a graft surveillance protocol using duplex scanning and over a two-year interval evaluated fifty-four lower extremity bypasses utilizing gra...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02016753
更新日期:1991-03-01 00:00:00
abstract::Infection of aortoiliac endografts is, to date, a rare complication of endovascular surgery. Staphylococcus species are the most common responsible pathogens, just as in cases with infected grafts after open aortic surgery. We report a case of a 65-year-old man with a history of diabetes mellitus and bladder cancer wh...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2006.05.005
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Length of stay (LOS) is a commonly used metric to optimize value in medical care. Although pathways have been developed for some procedures in vascular surgery to reduce LOS, they do not yet exist for thoracic endovascular aortic repair (TEVAR). The purpose of this study is to identify and define the risk fa...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.06.027
更新日期:2019-02-01 00:00:00
abstract::Any pulsatile neck mass after extracorporeal membrane oxygenation (ECMO) must be viewed as a pseudoaneurysm of the carotid artery until proven otherwise. Prompt diagnosis is necessary utilizing ultrasound. Angiography may not be necessary. Carotid artery pseudoaneurysm requires urgent surgical intervention to prevent ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900102
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:The Vessel Closure System (VCS) is commercially available since 1997. This clip system has proven to be successful for vascular anastomoses in access surgery. There is little experience with the VCS in peripheral vascular surgery. METHODS:A trial was conducted for patients with peripheral arterial disease, ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.avsg.2012.02.008
更新日期:2013-02-01 00:00:00
abstract::A patient with bilateral congenital aplasia of the deep femoral arteries is described. The condition was accompanied by aneurysms of the popliteal arteries. Besides the academic interest of such an anatomical rarity, the abnormality is of clinical importance insofar as acute ischemia of the extremity may occur in the ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(07)60078-8
更新日期:1990-09-01 00:00:00