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. 2020 Oct 1;40(6):1574–1599. doi: 10.1148/rg.2020200149

Figure 29b.

Central and peripheral arterial thrombosis in a severely ill 46-year-old man with COVID-19 in the ICU. (a, b) Axial (a) and sagittal (b) chest CT angiographic images show bibasilar areas of consolidation (black arrows in a), indicative of COVID-19 pneumonia, and a central aortic thrombosis with a thrombus attached to the wall of the aortic arch (white arrow in a and b). (c–f) Sagittal (c), coronal (d), and axial (e, f) CT angiographic images show a large thrombus extending from the abdominal aorta into the superior mesenteric artery origin (arrow in c), which resulted in bowel ischemia, evidenced by thickening of the watershed splenic flexure of the large bowel (arrow in d). Note the multifocal bilateral wedge-shaped renal cortical infarcts (arrows in e). Note also a nonocclusive thrombus in the left profunda femoris artery (white arrow in f), indicative of a concurrent presence of a peripheral thrombosis. There is normal opacification of the patent right profunda femoris artery (black arrow in f). This case demonstrates multifocal multisystem manifestations of COVID-19 complicated by coagulopathy that resulted in injury to various organs and systems. It is an example of the need for increased awareness among radiologists to thoroughly evaluate all covered anatomy for COVID-related complications.

Central and peripheral arterial thrombosis in a severely ill 46-year-old man with COVID-19 in the ICU. (a, b) Axial (a) and sagittal (b) chest CT angiographic images show bibasilar areas of consolidation (black arrows in a), indicative of COVID-19 pneumonia, and a central aortic thrombosis with a thrombus attached to the wall of the aortic arch (white arrow in a and b). (c–f) Sagittal (c), coronal (d), and axial (e, f) CT angiographic images show a large thrombus extending from the abdominal aorta into the superior mesenteric artery origin (arrow in c), which resulted in bowel ischemia, evidenced by thickening of the watershed splenic flexure of the large bowel (arrow in d). Note the multifocal bilateral wedge-shaped renal cortical infarcts (arrows in e). Note also a nonocclusive thrombus in the left profunda femoris artery (white arrow in f), indicative of a concurrent presence of a peripheral thrombosis. There is normal opacification of the patent right profunda femoris artery (black arrow in f). This case demonstrates multifocal multisystem manifestations of COVID-19 complicated by coagulopathy that resulted in injury to various organs and systems. It is an example of the need for increased awareness among radiologists to thoroughly evaluate all covered anatomy for COVID-related complications.