Endovascular Stent Thrombectomy in Patients With Acute Lower Limb Arterial Thrombosis on the Background of COVID-19

AIM Analysis of the outcomes of endovascular stent thrombectomy in patients with acute arterial thrombosis of the lower extremities on the background of COVID-19.MATERIAL AND METHODS This retrospective study for the period from January 1, 2020 to March 1, 2022 included 34 patients with acute lower l...

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Main Authors: I. S. Semyin, A. N. Ivanenko, A. S. Zharova, V. A. Pyatkov, I. L. Bakhtin, G. A. Sobolev, A. D. Kiselev, A. V. Korotkikh, A. N Kazantsev, K. P. Chernykh
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Language:Russian
Published: Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department 2023-04-01
Series:Неотложная медицинская помощь
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Online Access:https://www.jnmp.ru/jour/article/view/1585
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author I. S. Semyin
A. N. Ivanenko
A. S. Zharova
V. A. Pyatkov
I. L. Bakhtin
G. A. Sobolev
A. D. Kiselev
A. V. Korotkikh
A. N Kazantsev
K. P. Chernykh
author_facet I. S. Semyin
A. N. Ivanenko
A. S. Zharova
V. A. Pyatkov
I. L. Bakhtin
G. A. Sobolev
A. D. Kiselev
A. V. Korotkikh
A. N Kazantsev
K. P. Chernykh
author_sort I. S. Semyin
collection DOAJ
description AIM Analysis of the outcomes of endovascular stent thrombectomy in patients with acute arterial thrombosis of the lower extremities on the background of COVID-19.MATERIAL AND METHODS This retrospective study for the period from January 1, 2020 to March 1, 2022 included 34 patients with acute lower limb ischemia who were diagnosed with the novel coronavirus infection SARS-COV-2. Endovascular stent thrombectomy was performed according to the standard technique using a Destination 8F guiding sheath (Terumo), an Advantage 0.014`` guidewire (Terumo), and a Casper stent (Microvention, Terumo) as a stent retriever. In case of fragmentation of thrombotic masses in the guide sheath, manual aspiration of thrombi was performed using a standard 50,0 ml syringe. Self-expanding nitinol stents were implanted in 11 clinical cases.RESULTS Intraoperative bleeding from the puncture site of the artery developed in 14.7% of cases, which required additional manipulation to achieve hemostasis. Every tenth (11.8%) patient developed myocardial infarction, in 2.9% of cases — ischemic stroke. In the hospital postoperative period during the first hours after surgery, 26.5% of patients developed rethrombosis which required re-intervention. In 8.8% of cases, retrombectomy was unsuccessful, and limb amputation was performed. A fatal outcome occurred in 67.6% of cases, which was due to an increase in multiple organ failure and the development of sepsis.CONCLUSION Endovascular stent thrombectomy is characterized by a low risk of rethrombosis and amputation in the context of COVID-19.
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publishDate 2023-04-01
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spelling doaj-art-27e09e4ccaa043958395b9be78a71abd2025-08-20T03:35:36ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172023-04-0112116116910.23934/2223-9022-2023-12-1-161-169846Endovascular Stent Thrombectomy in Patients With Acute Lower Limb Arterial Thrombosis on the Background of COVID-19I. S. Semyin0A. N. Ivanenko1A. S. Zharova2V. A. Pyatkov3I. L. Bakhtin4G. A. Sobolev5A. D. Kiselev6A. V. Korotkikh7A. N Kazantsev8K. P. Chernykh9Department of Cardiovascular Surgery, Arkhangelsk Regional Clinical HospitalDepartment of Cardiovascular Surgery, Arkhangelsk Regional Clinical HospitalI.I. Mechnikov North-Western State Medical UniversityDepartment of Cardiovascular Surgery, Arkhangelsk Regional Clinical HospitalDepartment of Cardiovascular Surgery, Arkhangelsk Regional Clinical HospitalDepartment of Cardiovascular Surgery, Arkhangelsk Regional Clinical HospitalDepartment of Cardiovascular Surgery, Arkhangelsk Regional Clinical HospitalAmur State Medical AcademyCity Alexandrovskaya HospitalCity Alexandrovskaya HospitalAIM Analysis of the outcomes of endovascular stent thrombectomy in patients with acute arterial thrombosis of the lower extremities on the background of COVID-19.MATERIAL AND METHODS This retrospective study for the period from January 1, 2020 to March 1, 2022 included 34 patients with acute lower limb ischemia who were diagnosed with the novel coronavirus infection SARS-COV-2. Endovascular stent thrombectomy was performed according to the standard technique using a Destination 8F guiding sheath (Terumo), an Advantage 0.014`` guidewire (Terumo), and a Casper stent (Microvention, Terumo) as a stent retriever. In case of fragmentation of thrombotic masses in the guide sheath, manual aspiration of thrombi was performed using a standard 50,0 ml syringe. Self-expanding nitinol stents were implanted in 11 clinical cases.RESULTS Intraoperative bleeding from the puncture site of the artery developed in 14.7% of cases, which required additional manipulation to achieve hemostasis. Every tenth (11.8%) patient developed myocardial infarction, in 2.9% of cases — ischemic stroke. In the hospital postoperative period during the first hours after surgery, 26.5% of patients developed rethrombosis which required re-intervention. In 8.8% of cases, retrombectomy was unsuccessful, and limb amputation was performed. A fatal outcome occurred in 67.6% of cases, which was due to an increase in multiple organ failure and the development of sepsis.CONCLUSION Endovascular stent thrombectomy is characterized by a low risk of rethrombosis and amputation in the context of COVID-19.https://www.jnmp.ru/jour/article/view/1585thrombosisarterial thrombosisthrombectomyacute thrombosisacute ischemiacovid-19coronavirussars-cov-2stent thrombectomystent retriever
spellingShingle I. S. Semyin
A. N. Ivanenko
A. S. Zharova
V. A. Pyatkov
I. L. Bakhtin
G. A. Sobolev
A. D. Kiselev
A. V. Korotkikh
A. N Kazantsev
K. P. Chernykh
Endovascular Stent Thrombectomy in Patients With Acute Lower Limb Arterial Thrombosis on the Background of COVID-19
Неотложная медицинская помощь
thrombosis
arterial thrombosis
thrombectomy
acute thrombosis
acute ischemia
covid-19
coronavirus
sars-cov-2
stent thrombectomy
stent retriever
title Endovascular Stent Thrombectomy in Patients With Acute Lower Limb Arterial Thrombosis on the Background of COVID-19
title_full Endovascular Stent Thrombectomy in Patients With Acute Lower Limb Arterial Thrombosis on the Background of COVID-19
title_fullStr Endovascular Stent Thrombectomy in Patients With Acute Lower Limb Arterial Thrombosis on the Background of COVID-19
title_full_unstemmed Endovascular Stent Thrombectomy in Patients With Acute Lower Limb Arterial Thrombosis on the Background of COVID-19
title_short Endovascular Stent Thrombectomy in Patients With Acute Lower Limb Arterial Thrombosis on the Background of COVID-19
title_sort endovascular stent thrombectomy in patients with acute lower limb arterial thrombosis on the background of covid 19
topic thrombosis
arterial thrombosis
thrombectomy
acute thrombosis
acute ischemia
covid-19
coronavirus
sars-cov-2
stent thrombectomy
stent retriever
url https://www.jnmp.ru/jour/article/view/1585
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