Femoral Arterial Thrombosis in a Young Adult after Nonsevere COVID-19.
Identifieur interne : 000F40 ( Main/Exploration ); précédent : 000F39; suivant : 000F41Femoral Arterial Thrombosis in a Young Adult after Nonsevere COVID-19.
Auteurs : Florian Veyre [France] ; Corinne Poulain-Veyre [France] ; Aurélie Esparcieux [France] ; Nicolas Monsarrat [France] ; Abdellah Aouifi [France] ; Joel Lapeze [France] ; Philippe Chatelard [France]Source :
- Annals of vascular surgery [ 1615-5947 ] ; 2020.
Abstract
INTRODUCTION
Few cases of arterial thromboembolisms have been reported after novel coronavirus disease 2019 (COVID-19) in case of severe infection or in elderly patients. We report a case of femoral arterial thrombosis in a young patient after nonsevere infection.
CASE DESCRIPTION
A common femoral artery thrombosis extended in the first third of superficial and profunda femoral arteries associated with tibial posterior and popliteal artery thrombosis was diagnosed in a 24-year-old man complaining of right lower limb pain for one month. The evolution was good after anticoagulation and antiaggregant treatments and thrombectomy. Etiologic assessment was negative except for nonsevere COVID-19.
DISCUSSION
COVID-19 accesses host cells via angiotensin-converting enzyme 2 protein, abundant in the lungs, which is also expressed by endothelial cells and is associated with important inflammatory syndrome and coagulopathy, leading to vascular lesions. Thrombosis prevalence is not fully established and seems to be higher in case of major inflammation and in the intensive care unit (ICU). Arterial thromboembolisms are described in many vascular territories, each time in elderly patients, or in case of severe infection. We described a femoral arterial thrombosis in a young patient with negative etiological assessment except nonsevere COVID-19. Treatment consists in anticoagulation and antiaggregant drugs and thrombectomy. Preventing venous thromboembolism treatment is recommended in case of severe infection or in the ICU, but there is no clear recommendation for arterial thromboembolism prevention. This case should lead us to be very careful of the arterial event risk even if the infection is nonsevere and the patient is young.
DOI: 10.1016/j.avsg.2020.07.013
PubMed: 32736027
PubMed Central: PMC7386281
Affiliations:
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Electronic address: ph.chatelard@wanadoo.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Chirurgie Cardiaque et Vasculaire, Infirmerie Protestante de Lyon, Caluire et Cuire</wicri:regionArea><wicri:noRegion>Caluire et Cuire</wicri:noRegion><wicri:noRegion>Caluire et Cuire</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32736027</idno><idno type="pmid">32736027</idno><idno type="doi">10.1016/j.avsg.2020.07.013</idno><idno type="pmc">PMC7386281</idno><idno type="wicri:Area/Main/Corpus">000769</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000769</idno><idno type="wicri:Area/Main/Curation">000769</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000769</idno><idno type="wicri:Area/Main/Exploration">000769</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Femoral Arterial Thrombosis in a Young Adult after Nonsevere COVID-19.</title><author><name sortKey="Veyre, Florian" sort="Veyre, Florian" uniqKey="Veyre F" first="Florian" last="Veyre">Florian Veyre</name><affiliation wicri:level="4"><nlm:affiliation>Université Claude-Bernard Lyon 1, Domaine Rockefeller, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Claude-Bernard Lyon 1, Domaine Rockefeller, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName><orgName type="university">Université Claude Bernard Lyon 1</orgName></affiliation></author><author><name sortKey="Poulain Veyre, Corinne" sort="Poulain Veyre, Corinne" uniqKey="Poulain Veyre C" first="Corinne" last="Poulain-Veyre">Corinne Poulain-Veyre</name><affiliation wicri:level="3"><nlm:affiliation>Médecine Vasculaire, Vienne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Médecine Vasculaire, Vienne</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Vienne (Isère)</settlement></placeName></affiliation></author><author><name sortKey="Esparcieux, Aurelie" sort="Esparcieux, Aurelie" uniqKey="Esparcieux A" first="Aurélie" last="Esparcieux">Aurélie Esparcieux</name><affiliation wicri:level="1"><nlm:affiliation>Service de Médecine Interne et Maladies Infectieuses, Infirmerie Protestante de Lyon, Caluire et Cuire, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne et Maladies Infectieuses, Infirmerie Protestante de Lyon, Caluire et Cuire</wicri:regionArea><wicri:noRegion>Caluire et Cuire</wicri:noRegion><wicri:noRegion>Caluire et Cuire</wicri:noRegion></affiliation></author><author><name sortKey="Monsarrat, Nicolas" sort="Monsarrat, Nicolas" uniqKey="Monsarrat N" first="Nicolas" last="Monsarrat">Nicolas Monsarrat</name><affiliation wicri:level="1"><nlm:affiliation>Service de Cardiologie, Infirmerie Protestante de Lyon, Caluire et Cuire, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Cardiologie, Infirmerie Protestante de Lyon, Caluire et Cuire</wicri:regionArea><wicri:noRegion>Caluire et Cuire</wicri:noRegion><wicri:noRegion>Caluire et Cuire</wicri:noRegion></affiliation></author><author><name sortKey="Aouifi, Abdellah" sort="Aouifi, Abdellah" uniqKey="Aouifi A" first="Abdellah" last="Aouifi">Abdellah Aouifi</name><affiliation wicri:level="1"><nlm:affiliation>Service de Réanimation, Infirmerie Protestante de Lyon, Caluire et Cuire, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation, Infirmerie Protestante de Lyon, Caluire et Cuire</wicri:regionArea><wicri:noRegion>Caluire et Cuire</wicri:noRegion><wicri:noRegion>Caluire et Cuire</wicri:noRegion></affiliation></author><author><name sortKey="Lapeze, Joel" sort="Lapeze, Joel" uniqKey="Lapeze J" first="Joel" last="Lapeze">Joel Lapeze</name><affiliation wicri:level="1"><nlm:affiliation>Service de Chirurgie Cardiaque et Vasculaire, Infirmerie Protestante de Lyon, Caluire et Cuire, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Chirurgie Cardiaque et Vasculaire, Infirmerie Protestante de Lyon, Caluire et Cuire</wicri:regionArea><wicri:noRegion>Caluire et Cuire</wicri:noRegion><wicri:noRegion>Caluire et Cuire</wicri:noRegion></affiliation></author><author><name sortKey="Chatelard, Philippe" sort="Chatelard, Philippe" uniqKey="Chatelard P" first="Philippe" last="Chatelard">Philippe Chatelard</name><affiliation wicri:level="1"><nlm:affiliation>Service de Chirurgie Cardiaque et Vasculaire, Infirmerie Protestante de Lyon, Caluire et Cuire, France. Electronic address: ph.chatelard@wanadoo.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Chirurgie Cardiaque et Vasculaire, Infirmerie Protestante de Lyon, Caluire et Cuire</wicri:regionArea><wicri:noRegion>Caluire et Cuire</wicri:noRegion><wicri:noRegion>Caluire et Cuire</wicri:noRegion></affiliation></author></analytic><series><title level="j">Annals of vascular surgery</title><idno type="eISSN">1615-5947</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>Few cases of arterial thromboembolisms have been reported after novel coronavirus disease 2019 (COVID-19) in case of severe infection or in elderly patients. We report a case of femoral arterial thrombosis in a young patient after nonsevere infection.</p></div><div type="abstract" xml:lang="en"><p><b>CASE DESCRIPTION</b></p><p>A common femoral artery thrombosis extended in the first third of superficial and profunda femoral arteries associated with tibial posterior and popliteal artery thrombosis was diagnosed in a 24-year-old man complaining of right lower limb pain for one month. The evolution was good after anticoagulation and antiaggregant treatments and thrombectomy. Etiologic assessment was negative except for nonsevere COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>DISCUSSION</b></p><p>COVID-19 accesses host cells via angiotensin-converting enzyme 2 protein, abundant in the lungs, which is also expressed by endothelial cells and is associated with important inflammatory syndrome and coagulopathy, leading to vascular lesions. Thrombosis prevalence is not fully established and seems to be higher in case of major inflammation and in the intensive care unit (ICU). Arterial thromboembolisms are described in many vascular territories, each time in elderly patients, or in case of severe infection. We described a femoral arterial thrombosis in a young patient with negative etiological assessment except nonsevere COVID-19. Treatment consists in anticoagulation and antiaggregant drugs and thrombectomy. Preventing venous thromboembolism treatment is recommended in case of severe infection or in the ICU, but there is no clear recommendation for arterial thromboembolism prevention. This case should lead us to be very careful of the arterial event risk even if the infection is nonsevere and the patient is young.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32736027</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1615-5947</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jul</Month><Day>28</Day></PubDate></JournalIssue><Title>Annals of vascular surgery</Title><ISOAbbreviation>Ann Vasc Surg</ISOAbbreviation></Journal><ArticleTitle>Femoral Arterial Thrombosis in a Young Adult after Nonsevere COVID-19.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S0890-5096(20)30604-X</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.avsg.2020.07.013</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Few cases of arterial thromboembolisms have been reported after novel coronavirus disease 2019 (COVID-19) in case of severe infection or in elderly patients. We report a case of femoral arterial thrombosis in a young patient after nonsevere infection.</AbstractText><AbstractText Label="CASE DESCRIPTION" NlmCategory="METHODS">A common femoral artery thrombosis extended in the first third of superficial and profunda femoral arteries associated with tibial posterior and popliteal artery thrombosis was diagnosed in a 24-year-old man complaining of right lower limb pain for one month. The evolution was good after anticoagulation and antiaggregant treatments and thrombectomy. Etiologic assessment was negative except for nonsevere COVID-19.</AbstractText><AbstractText Label="DISCUSSION" NlmCategory="CONCLUSIONS">COVID-19 accesses host cells via angiotensin-converting enzyme 2 protein, abundant in the lungs, which is also expressed by endothelial cells and is associated with important inflammatory syndrome and coagulopathy, leading to vascular lesions. Thrombosis prevalence is not fully established and seems to be higher in case of major inflammation and in the intensive care unit (ICU). Arterial thromboembolisms are described in many vascular territories, each time in elderly patients, or in case of severe infection. We described a femoral arterial thrombosis in a young patient with negative etiological assessment except nonsevere COVID-19. Treatment consists in anticoagulation and antiaggregant drugs and thrombectomy. Preventing venous thromboembolism treatment is recommended in case of severe infection or in the ICU, but there is no clear recommendation for arterial thromboembolism prevention. This case should lead us to be very careful of the arterial event risk even if the infection is nonsevere and the patient is young.</AbstractText><CopyrightInformation>Copyright © 2020 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Veyre</LastName><ForeName>Florian</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Université Claude-Bernard Lyon 1, Domaine Rockefeller, Lyon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Poulain-Veyre</LastName><ForeName>Corinne</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Médecine Vasculaire, Vienne, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Esparcieux</LastName><ForeName>Aurélie</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service de Médecine Interne et Maladies Infectieuses, Infirmerie Protestante de Lyon, Caluire et Cuire, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Monsarrat</LastName><ForeName>Nicolas</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Service de Cardiologie, Infirmerie Protestante de Lyon, Caluire et Cuire, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aouifi</LastName><ForeName>Abdellah</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service de Réanimation, Infirmerie Protestante de Lyon, Caluire et Cuire, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lapeze</LastName><ForeName>Joel</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Service de Chirurgie Cardiaque et Vasculaire, Infirmerie Protestante de Lyon, Caluire et Cuire, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chatelard</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Service de Chirurgie Cardiaque et Vasculaire, Infirmerie Protestante de Lyon, Caluire et Cuire, France. Electronic address: ph.chatelard@wanadoo.fr.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>07</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Ann Vasc Surg</MedlineTA><NlmUniqueID>8703941</NlmUniqueID><ISSNLinking>0890-5096</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>06</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>07</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>07</Month><Day>14</Day></PubMedPubDate><PubMedPubDate 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