Hybrid revascularization in a patient with Covid-19 and chronic limb ischemia stage IV

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The authors report hybrid treatment of a patient with angina pectoris class II, multiple previous reconstructive interventions on the aortofemoral segment and chronic ischemia of the left lower limb stage IV and concomitant COVID-19. Coronary angiography was performed after regression of infectious disease under antiviral therapy. Occlusion of the left anterior descending artery was observed that required LAD stenting. On the next day, hybrid revascularization of the lower extremities was implemented: thrombectomy and endarterectomy from the branch of the aorto-femoral bypass graft and deep femoral artery at the first stage, stenting of the orifice of proximal branch of aorto-femoral bypass graft at the second stage, endarterectomy from superficial femoral artery, recanalization and stenting of superficial femoral artery and popliteal artery at the third stage and prosthetic- femoral bypass with autologous vein at the fourth stage. Postoperative angiography revealed patent stents and no residual stenoses. The choice in favor of these procedures and step-by-step approach has been substantiated. The authors emphasized effectiveness and safety of this treatment strategy.

Keywords:

aorto-femoral bypass

limb-threating ischemia

endovascular intervention

hybrid revascularization

comorbidity

thrombosis

COVID-19

new coronavirus

novel coronavirus infection

Authors:

Chernyavsky M.A.

Almazov National Medical Research Center

ORCID: 0000-0003-1214-0150

Susanin N.V.

Almazov National Medical Research Center

ORCID: 0000-0002-8374-1503

Soloviev V.A.

Almazov National Medical Research Center;
City Alexandrovskaya Hospital

Kazantsev A.N.

St. Petersburg City Alexandrovskaya Hospital

SPIN RSCI: 8396-1845
Scopus AuthorID: 57196122083
ORCID: 0000-0002-1115-609X

Received:

11.09.2021

Accepted:

15.10.2021

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