Kukulski, Leszek and Scharf, Gregor and Schierling, Wilma and Pfister, Karin and Linnemann, Birgit (2023) Spontaneous dissection of the superior mesenteric artery related to COVID-19 Case report and systematic review of the literature. VASA-EUROPEAN JOURNAL OF VASCULAR MEDICINE, 52 (2). pp. 107-118. ISSN 0301-1526, 1664-2872
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Background: Spontaneous peripheral dissections are rare, and in a substantial number of cases, the underlying aetiology remains unclear. Patients and methods: We report the case of a 63-year-old male patient with a recent asymptomatic SARS-CoV-2 infection who presented with sudden-onset intermittent abdominal pain. Imaging studies revealed a dissection of the superior mesenteric artery (SMA) and large-vessel vasculitis involving the SMA as well as the carotid, subclavian, axillary and femoropopliteal arteries. In the absence of other predisposing factors, we supposed an association with prior COVID-19 and performed a systematic review of the literature to search for similar cases with arterial dissection related to acute or recent SARS-CoV-2 infection. Results: We identified 25 cases, including ours: 13 males and 12 females, with a median age of 48 years. In 22/25 patients, arterial dissection occurred within 4 weeks after the diagnosis of COVID-19 and involved the cerebral (11/25; 44%), coronary (10/25; 40%), splanchnic (3/25; 12%) and renal (2/25; 8%) arteries. Conclusions: Although initially known for its respiratory manifestations, it has become evident that SARS-CoV-2 not only infects pneumocytes but also enters the vascular endothelium, leading to endothelial dysfunction and hypercoagulability and - as shown in our case - large-vessel vasculitis, which may predispose patients to intramural haemorrhage and arterial dissection.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PATIENT; ASSOCIATION; VASCULITIS; INFECTION; COVID-19; arterial dissection; vasculitis; superior mesenteric artery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Gefäßchirurgie Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 08 Mar 2024 07:10 |
| Last Modified: | 08 Mar 2024 07:10 |
| URI: | https://pred.uni-regensburg.de/id/eprint/59337 |
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