The results of thrombectomy from the arteries of the lower extremities in patients infected with SARS-CoV-2 Omicron variant with different severity of respiratory failure

Abstract

Goal Analysis of the results of thrombectomy from the arteries of the lower extremities in patients with COVID-19 against the background of different severity of respiratory failure. Materials and Methods This retrospective, cohort, comparative study for the period from 05/01/2022 to 20/07/2022 included 305 patients with acute thrombosis of the arteries of the lower extremities against the background of the course of COVID-19 (SARS-CoV-2 Omicron variant). Depending on the type of oxygen support, 3 groups of patients were formed: group 1 ( n = 168) – oxygen insufflation through nasal cannulas; group 2 ( n = 92) – non-invasive lung ventilation; and group 3 ( n = 45) – artificial lung ventilation. Results Myocardial infarction and ischemic stroke were not detected in the total sample. The highest number of deaths (group 1: 5.3%, n = 9; group 2: 72.8%, n = 67; group 3: 100%, n = 45; p < 0.0001), rethrombosis (group 1 : 18.4%, n = 31; group 2: 69.5%, n = 64; group 3: 91.1%, n = 41; p < 0.0001), and limb amputations (group 1: 9.5%, n = 16; group 2: 56.5%, n = 52; group 3: 91.1%, n = 41; p < 0.0001) was recorded in group 3 (ventilated) patients. Conclusion In patients infected with COVID-19 and on artificial lung ventilation, a more aggressive course of the disease is noted, expressed in an increase in laboratory parameters (C-reactive protein, ferritin, interleukin-6, and D-dimer) of the degree of pneumonia (CT-4 in overwhelming number) and localization of thrombosis of the arteries of the lower extremities, mainly in the tibial arteries.

Vertebral triangle of doctor A.N. Kazantsev - double vertebral artery in V3 segment

“…In the case of the development of hemodynamically significant stenosis of the internal carotid artery and with complete patency of the vertebral artery, the formation of vertebrobasilar insufficiency due to a deficiency of hemocirculation is possible [13] . In such a situation, the effect of carotid endarterectomy leads to regression of vertebrobasilar insufficiency [ [16] , [17] , [18] , [19] , [20] ]. In our clinical case, stenting of the left vertebral artery had a protective effect in order to eliminate circulatory insufficiency in the basin of the left middle cerebral artery.…”