Aortic Thrombus in patients with Severe Covid-19. Review of three cases

Carranza, María de; Salazar, Danilo; Troya, Jesús; Alcázar, Roberto; Peña, Cristina García-De la; Muñoz, Nuria Malajovich

doi:10.21203/rs.3.rs-28657/v1

Cited by 6 publications

(10 citation statements)

References 16 publications

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“…The more commonly reported events are in relation to deep vein thrombosis and pulmonary embolism [4]. However, the evidence about arterial thrombosis in patients with COVID-19 is limited [5].…”

Section: Discussionmentioning

confidence: 99%

“…Although there is a risk of thrombosis, the thrombosis in the arch of the aorta is rare. There have been very few case reports wherein the association of floating thrombus in the arch of the aorta in association with COVID-19 has been described in the literature [5]. The mean time for the appearance of thrombus has been 12-17 days [9].…”

Section: Discussionmentioning

confidence: 99%

“…LMWH is the mainstay treatment for floating thrombus as well, in this patient also, who was already on enoxaparin the dose was increased to 60 mg subcutaneous per day, and on discharge, there was a decrease in size of thrombus and also a significant improvement in the clinical condition of the patient. It is advocated to give full-dose anticoagulant for the management and to continue anticoagulants for up to 3 months post-discharge for these patients [5]. The surgical management of the thrombus has been suggested by few authors [12].…”

Section: Discussionmentioning

confidence: 99%

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Floating thrombus in the arch of the aorta: A diagnostic dilemma in coronavirus disease 2019

Kapoor¹,

Verma²,

Choudhary³

et al. 2021

IJCR

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Coronavirus disease 2019 primarily involves the respiratory system, however, hypercoagulability and thromboembolism are its unique and common association. COVID-19 may predispose patients to an increased risk of thrombotic complications through various pathophysiologic mechanisms, such as inflammation, immobilization, endothelial dysfunction, and a hypercoagulable state. Therefore, a high index of clinical suspicion is needed for diagnosing thrombotic complications such as floating thrombus in the arch of the aorta as described in this case report and prompt anticoagulation should be started to prevent life-threatening complications. We describe a rare presentation of a patient who presented to intensive care unit of our hospital with respiratory symptoms and was being treated for COVID-19 and despite the management as per COVID protocol was difficult to wean off from the non-invasive ventilation. We will focus on how we arrived at this rare diagnosis "floating thrombus in the arch of aorta" and further management of the case.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Floating thrombus in the arch of the aorta: A diagnostic dilemma in coronavirus disease 2019

Kapoor¹,

Verma²,

Choudhary³

et al. 2021

IJCR

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“…These findings suggest that VTE is more common than arterial thromboembolism in SARS-CoV-2-infected patients. To date, there are several ways in which the SARS-CoV-2 pandemic may affect the thrombosis events, including hyper-inflammatory processes, diffuse intravascular coagulation, platelet activation, severe hypoxemia, and ECs dysfunction ( de Carranza et al, 2020 ; Iba et al, 2020 ). However, given the pathogenesis of thrombosis events is multifactorial and has not been fully understood, further research is required to elucidate the molecular basis of thrombosis and pathophysiological mechanisms in SARS-CoV-2-infected patients.…”

Section: Clinical Characteristics Of Severe Acute Respiratory Syndrommentioning

confidence: 99%

Research Progress of Genetic Structure, Pathogenic Mechanism, Clinical Characteristics, and Potential Treatments of Coronavirus Disease 2019

et al. 2020

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Coronavirus disease 2019 (COVID-19) is a global pandemic infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and currently affects more than 8 million people worldwide. SARS-CoV-2 mainly invades the cells by binding to the angiotensin converting enzyme 2 (ACE2) receptor, leading to the injury of respiratory system, cardiovascular system, digestive system, and urinary system, and even secondary to acute respiratory distress syndrome (ARDS) and systemic inflammatory response, resulting in multiple organ failure. In this review, mainly focusing on biogenesis and pathogenic mechanisms, we describe the recent progress in our understanding of SARS-CoV-2 and then summarize and discuss its crucial clinical characteristics and potential mechanism in different systems. Additionally, we discuss the potential treatments for COVID-19, aiming at a better understanding of the pathogenesis of SARS-CoV-2 and providing new ideas for the personalized treatment of COVID-19.

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“…Acute aortic occlusion has also been linked as an extrapulmonary manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19. The virus creates a hypercoagulable state by upregulating procoagulant cytokines within endothelial cells of blood vessels [3].…”

Section: Introductionmentioning

confidence: 99%

Fibrinolytic Administration via EkoSonic™ Endovascular System (EKOS) Catheter Used in Acute Aortic Occlusion Secondary to COVID-19

Moynihan¹,

Richardson²,

Loveridge³

2021

Cureus

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 is the virus responsible for the 2019 global pandemic. Pulmonary complications of COVID-19 are well established in the literature. However, the virus causes numerous extrapulmonary manifestations, notably acute aortic occlusion (AAO). COVID-19 creates a hypercoagulable state via the upregulation of numerous procoagulant cytokines in endothelial cells of blood vessels. We present a case of a 63-year-old patient without a previous history of prothrombotic disorders who developed AAO in the distal abdominal aorta and bilateral common iliac arteries after contracting COVID-19. The patient was a poor surgical candidate and was treated with fibrinolytics that were administered via an EkoSonic™ Endovascular System (EKOS) catheter using a bilateral transfemoral approach. This case highlights a unique treatment option for non-surgical candidates with AAO.

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Aortic Thrombus in patients with Severe Covid-19. Review of three cases

Cited by 6 publications

References 16 publications

Floating thrombus in the arch of the aorta: A diagnostic dilemma in coronavirus disease 2019

Floating thrombus in the arch of the aorta: A diagnostic dilemma in coronavirus disease 2019

Research Progress of Genetic Structure, Pathogenic Mechanism, Clinical Characteristics, and Potential Treatments of Coronavirus Disease 2019

Fibrinolytic Administration via EkoSonic™ Endovascular System (EKOS) Catheter Used in Acute Aortic Occlusion Secondary to COVID-19

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