COVID-19 and acute limb ischemia: a systematic review.
J Cardiovasc Surg (Torino)
; 62(6): 542-547, 2021 Dec.
Article
in English
| MEDLINE | ID: covidwho-1441428
ABSTRACT
INTRODUCTION:
The main goal of this systematic review was to analyze the outcomes of acute limb ischemia (ALI) in patients suffering from the novel Coronavirus COVID-19 (SARS-CoV-2). EVIDENCE ACQUISITION A systematic review on Medline and Embase was conducted up to May 15, 2021. All papers were sorted by abstract and full text by two independent authors. Systematic reviews, commentaries, and studies that did not distinguish status of COVID-19 infection were excluded from review. Patient demographics were recorded along with modality of treatment (endovascular and/or surgical). We analyzed 30-day outcomes, including mortality. Primary outcome was to evaluate clinical characteristic of ALI in patients affected by SARS-CoV-2 in term of location of ischemia, treatment options and 30-day outcomes. EVINDENCESYNTHESIS:
We selected 36 articles with a total of 194 patients. Most patients were male (80%) with a median age of 60 years old. The treatment most used was thromboembolectomy (31% of all surgical interventions). A total of 32 patients (19%) were not submitted to revascularization due to critical status. The rate of technical success was low (68%), and mortality rate was high (35%).CONCLUSIONS:
This review confirms that SARS-CoV-2 is associated with a high risk of ALI. Further studies are needed to investigate the association and elucidate potential mechanisms, which may include a hypercoagulable state and hyperactivation of the immune response. Furthermore, management of ALI is not standardized and depends on patient condition and extension of the thrombosed segment. ALI in COVID-19 patients is associated with high risk of failure of revascularization and perioperative mortality.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Vascular Surgical Procedures
/
Blood Coagulation
/
Thrombophilia
/
Peripheral Arterial Disease
/
COVID-19
/
Ischemia
/
Anticoagulants
Type of study:
Experimental Studies
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
J Cardiovasc Surg (Torino)
Year:
2021
Document Type:
Article
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