tetano
Editor, Senior Moderator
Cureus
. 2022 Oct 19;14(10):e30467.
doi: 10.7759/cureus.30467. eCollection 2022 Oct.
Treatment With EkoSonic™ Endovascular System (EKOS®) of Massive Pulmonary Thrombosis Following Recovery From COVID-19 Infection
Ugur Cetingok Sr[SUP] 1 [/SUP], Cayan Akkoyun[SUP] 2 [/SUP], Zulkuf Isik[SUP] 3 [/SUP], Orhan Gungor[SUP] 4 [/SUP]
Affiliations
Abstract
COVID-19 infection caused by the new coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infection with symptoms and results ranging from mild flu-like symptoms to severe respiratory failure leading to death. The risk of thrombosis increases due to hypercoagulation in COVID-19 infection. All causes (endothelial injury, stasis, and hypercoagulopathy) known as Virchow's triad contribute to thrombosis in COVID-19 infection. However, the pathogenesis of hypercoagulability in COVID-19 is still unknown. In this article, we discuss the unique multiple thrombosis events following recovery from COVID-19 infection and our treatment strategy for pulmonary thrombosis. The patient had symptoms of dry cough, fever, and myalgia two months ago. His polymerase chain reaction (PCR) test for COVID-19 was positive, but there was no need for hospitalization. His symptoms resolved within seven days. But, thrombosis of the superior mesenteric artery (SMA) occurred one month after the COVID-19 infection, and bowel resection was performed. He was admitted to our hospital with dyspnea, chest pain, palpitations, and hoarseness. Further evaluation showed tachycardia, hypotension, tachypnea, and anxiety. Peripheral oxygen saturation (SpO[SUB]2[/SUB]) was 86% at room air. He had hemodynamic instability, right ventricular (RV) dysfunction, and D-Dimer elevation. Pulmonary Embolism Severity Index (PESI) was calculated as 149. The patient was in the high-risk group. Our Pulmonary Embolism Response Team (PERT) decided to apply catheter-directed thrombolysis (CDT) for the treatment of pulmonary thrombosis. The EkoSonic™ Endovascular System (EKOS) (Boston Scientific Corporation, Marlborough, USA) was used for the treatment.
Keywords: accelerated thrombolysis; covid-19 infection; ekos catheter; pulmonary artery thrombosis; pulmonary embolism (pe); systemic thrombolysis.
. 2022 Oct 19;14(10):e30467.
doi: 10.7759/cureus.30467. eCollection 2022 Oct.
Treatment With EkoSonic™ Endovascular System (EKOS®) of Massive Pulmonary Thrombosis Following Recovery From COVID-19 Infection
Ugur Cetingok Sr[SUP] 1 [/SUP], Cayan Akkoyun[SUP] 2 [/SUP], Zulkuf Isik[SUP] 3 [/SUP], Orhan Gungor[SUP] 4 [/SUP]
Affiliations
- PMID: 36407161
- PMCID: PMC9673463
- DOI: 10.7759/cureus.30467
Abstract
COVID-19 infection caused by the new coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infection with symptoms and results ranging from mild flu-like symptoms to severe respiratory failure leading to death. The risk of thrombosis increases due to hypercoagulation in COVID-19 infection. All causes (endothelial injury, stasis, and hypercoagulopathy) known as Virchow's triad contribute to thrombosis in COVID-19 infection. However, the pathogenesis of hypercoagulability in COVID-19 is still unknown. In this article, we discuss the unique multiple thrombosis events following recovery from COVID-19 infection and our treatment strategy for pulmonary thrombosis. The patient had symptoms of dry cough, fever, and myalgia two months ago. His polymerase chain reaction (PCR) test for COVID-19 was positive, but there was no need for hospitalization. His symptoms resolved within seven days. But, thrombosis of the superior mesenteric artery (SMA) occurred one month after the COVID-19 infection, and bowel resection was performed. He was admitted to our hospital with dyspnea, chest pain, palpitations, and hoarseness. Further evaluation showed tachycardia, hypotension, tachypnea, and anxiety. Peripheral oxygen saturation (SpO[SUB]2[/SUB]) was 86% at room air. He had hemodynamic instability, right ventricular (RV) dysfunction, and D-Dimer elevation. Pulmonary Embolism Severity Index (PESI) was calculated as 149. The patient was in the high-risk group. Our Pulmonary Embolism Response Team (PERT) decided to apply catheter-directed thrombolysis (CDT) for the treatment of pulmonary thrombosis. The EkoSonic™ Endovascular System (EKOS) (Boston Scientific Corporation, Marlborough, USA) was used for the treatment.
Keywords: accelerated thrombolysis; covid-19 infection; ekos catheter; pulmonary artery thrombosis; pulmonary embolism (pe); systemic thrombolysis.