COVID-19 and acute limb ischemia: a systematic review
| Autor: | Max V. Wohlauer, Luca Attisani, Alessandro Pucci, Gabriele Piffaretti, Raffaello Bellosta, Giorgio Luoni, Luca Luzzani, Daniele Bissacco, Matteo Pegorer, Alberto M. Settembrini |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) medicine.medical_treatment MEDLINE Ischemia Revascularization Risk Assessment Peripheral Arterial Disease Postoperative Complications Risk Factors Internal medicine Medicine Humans Thrombophilia Blood Coagulation SARS-CoV-2 business.industry Mortality rate Anticoagulants COVID-19 General Medicine Perioperative Middle Aged medicine.disease Limb ischemia Peripheral arterial disease Vascular surgical procedures Acute Disease Female Treatment Outcome Vascular Surgical Procedures Systematic review Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of cardiovascular surgery. 62(6) |
| ISSN: | 1827-191X |
| Popis: | Introduction The main goal of this systematic review is to analyze the outcomes of acute limb ischemia (ALI) in patients suffering from the novel Coronavirus COVID-19 (Sars-Cov-2). Evidence of 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. Evindence synthesis We selected 36 articles with a total of 194 patients. The majority of 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's condition and extension of the thrombosed segment. ALI in COVID-19 patients is associated with high risk of failure of revascularization and perioperative mortality. |
| Databáze: | OpenAIRE |
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