ABSTRACT
Treatment of patients with atherosclerotic lesion of the arteries of the limb is currently an relevance and largely unsolved problem. The severity of the course is aggravated by the presence of numerous risk factors and concomitant diseases, especially at present in the context of the ongoing COVID-19 pandemic. The problem of this pathology has been aggravating the relatively stable course of atherosclerosis for two years, causing increasingly rapid and severe thrombotic complications. A new coronavirus infection dictates the need to review the management of patients with cardiovascular pathology. The paper presents an overview of articles and studies devoted to the treatment of patients with both chronic and acute limb ischemia, who have had a new coronavirus infection. There is also a review of a number of articles devoted directly to COVID-19 and its impact on the human body. The search for articles was carried out on the PubMed Internet resource and affected articles published in the period from January 2020 to February 2022. It was determined that the course of limb ischemia is complicated by coagulopathic disorders and the development of systemic thrombosis provoked by COVID-19. Unfortunately, at the moment there are no approved treatment regimens and the using of anticoagulant drugs that would not only take into account the features associated with infection, but also meet the requirements of safety and efficacy. It only confirms the relevance of the problem. © 2021 Grudnaya i Serdechno-Sosudistaya Khirurgiya. All right reserved.
ABSTRACT
A 54-year-old woman with leukemia presented with coronavirus disease 2019 and a right upper-extremity indwelling peripherally inserted central catheter line for chemotherapy administration. On hospital admission day 9, she developed acute right upper-extremity edema and pain. Ultrasound demonstrated complete superficial and deep venous thrombosis up to the proximal subclavian vein. Her examination result was consistent with acute phlegmasia cerulea dolens and compartment syndrome, but respiratory instability prevented transfer and vascular surgery intervention. Instead, we performed bedside fasciotomies and administered therapeutic heparin, and the limb was salvaged. This case underscores the potential for successful limb salvage in patients with phlegmasia in the setting of coronavirus disease 2019 via compartment release and therapeutic anticoagulation.