Table 1.
Clinical characteristics of nine patients presenting with peripheral large vessel arterial occlusion.
| Variable | Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 | Patient 6 | Patient 7 | Patient 8 | Patient 9 |
|---|---|---|---|---|---|---|---|---|---|
| Age - yr | 38 | 37 | 80 | 84 | 68 | 77 | 69 | 93 | 89 |
| Sex | Male | Female | Female | Male | Female | Male | Female | Female | Female |
| Medical history and risk factors | Hypertension, obese | Obese, hypertension, diabetes, cerebral vascular accident | Atrial fibrillation, hyperlipidemia | Atrial fibrillation, hypertension, hyperlipidemia | Obese, diabetes, hypertension | Obese, hypertension, hyperlipidemia, rheumatoid arthritis | Hypertension, hyperlipidemia, rheumatoid arthritis | No past medical history | Hypertension |
| Home medications | Losartan | Chlorthalidone, clopidogrel | Apixiban | Metformin, pravastatin, amlodipine-olmesartan | Ibuprofen, insulin, levofloxan, simvastatin | Hydrochlorothiazide, tamsulosin, methotrexate | Amlodipine, insulin | None reported | None reported |
| Atherosclerosis | None | None | None | Mild | Moderate | Mild | Moderate | Severe | Moderate |
| COVID symptoms | Cough × 1 week | Dry cough and fever × 1 week | Diagnosed with COVID 1 week prior | Fever and SOB × 2 weeks. | Cough and SOB several days | Congestion and rhinorrhea × 2 weeks | Lack of appetite × 2 days | Altered mental status | Altered mental status |
| Time of COVID diagnosis to presentation? | Time of presentation | Time of presentation | 1 week prior | 1 week prior | Time of presentation | 1 week prior | Time of presentation | Time of presentation | Time of presentation |
| Imaging of Lung Bases for COVID-19 | Typical | Typical | Typical | Not included | Typical | Typical | Not included | Atypical. Pleural effusions and atelectasis. | No evidence for pneumonia. |
| Extremity symptoms | Right leg pain and right foot swelling × 9 days. | Acute onset right foot pain × 1 day. | Left upper extremity numbness & weakness × 1 h | Sudden onset cold left lower extremity. | Transferred from rehab facility with worsening foot pain and discoloration. | Sudden onset left leg pain and numbness 1 week after admission. | Worsening left leg pain and weakness × 2 days. | Transferred from nursing home and found to have lower extremity erythema, left greater than right, and cold to touch. | Pain when ambulating on right leg. |
| Imaging of extremities | 18 cm (intermediate length) occlusion from the right popliteal artery to the posterior tibial artery. | 77 cm (long segment) occlusion from the right proximal femoral artery to the feet. | 6 cm and 3.4 cm (two short segment) occlusions in the left proximal brachial artery and distal brachial artery respectively. | 3 cm and 52 cm (short segment and long segment) occlusions in the left common iliac artery and from the left popliteal artery to the feet respectively. | 25 cm (long segment) occlusion of the left distal femoral artery and popliteal artery stents. | 83 cm (long segment) occlusion of the entire left lower extremity from the common femoral artery to the feet. | 85 cm (long segment) occlusion of the entire left lower extremity from the common femoral artery to the feet. | 98 cm (long segment) occlusion of the entire left lower extremity from the common iliac artery to the feet. 28.5 cm (long length) occlusion involving the right femoral artery to the distal popliteal artery. | 18 cm (intermediate length) occlusion involving the left distal femoral artery and popliteal artery. Additional 20 cm (intermediate length) occlusion involving the right distal femoral and popliteal arteries. |
| Intervention | Popliteal artery cutdown, thrombectomy | Heparin infusion, thrombolysis, thrombectomy | Anticoagulation | Thrombectomy, fasciotomies | Left below knee amputation | Cut down, thrombectomy | Balloon angioplasty, cutdown, thrombectomy and above knee amputation | No intervention, palliative | Anticoagulation |
| Outcome | Discharged on anti-coagulation | Discharged on anticoagulation | Discharged on anticoagulation | Prolonged hospitalization | Discharged on anti-coagulation | Discharged on anti-coagulation | Discharged on anti-coagulation | Death | Discharged on anticoagulation |
| White-cell count – per mm3 (4500–11,000 mm3) | 11,900 | 10,700 | 12,000 | 10,000 | 21,100 | 13,800 | 23,000 | 14,800 | 6400 |
| Platelet count – per mm3 (150,000–450,000 mm3) | 370,000 | 429,000 | 563,000 | 325,000 | 613,000 | 323,000 | 427,000 | 313,000 | 228,000 |
| Prothrombin time – sec (12–14.2 s) | 13.3 | 14.6 | 13.9 | 16.9 | 18.6 | 15.2 | 15.8 | 15.7 | 14.8 |
| Fibrinogen – mg/dL (212–516 mg/dL) | – | 389 | 515 | 336 | 531 | – | 897 | 524 | – |
| D-dimer – ng/mL (0.0–500 ng/mL FEU) | 820 | >20,000 | 8210 | >20,000 | 2510 | 6080 | >20,000 | 2610 | – |
| Ferritin – ng/mL (15–150 ng/mL) | 86 | 232 | 395 | 464 | 1024 | 2055 | 2489 | 164 | – |
| Erythrocyte sedimentation rate – mm/h (0–20 mm/h) | – | – | 30 | 59 | 94 | 69 | 75 | 54 | – |
| C-reactive protein – mg/L (0.0–5.0 mg/L) | 15.2 | 62 | 37.6 | 171.3 | 75.1 | 56.5 | 234.2 | 41 | – |