Comparative analysis of long-term outcomes of endovascular revascularization for acute limb ischemia in patients with and without acute COVID-19 infection

Introduction. Endovascular revascularization in combination with catheter-controlled selective thrombolysis is the method of choice for the treatment of acute limb ischemia.

The aim of this study was to compare the long-term results of endovascular interventions with the use of selective catheter-controlled thrombolysis in patients with acute stage of new coronavirus infection COVID-19 and without it.

Materials and methods. The study included 121 patients with OIC who underwent endovascular revascularization with selective catheter-guided thrombolysis tissue plasminogen activator alteplase. The study group (n=71) consisted of patients operated on in the acute stage of the new coronavirus infection COVID-19, the control group (n=50) — without infection. Patency of the reconstructed arteries was assessed 6 and 12 months after surgery using ultrasound and CT angiography.

Results. Patency analysis of reconstructed arterial segments showed higher rates in the COVID-19 group both 6 months later (80,0 % vs. 73,7 %, p≤0,598) and 12 months after the intervention (70,6 % vs. 63,8 %, p≤0,621). Although the differences did not reach statistical significance, there was a tendency for better results in the COVID-19 group. The incidence of late retrombosis was 32,8 % in the general endovascular treatment group, while the distribution between the groups was as follows: 10 patients in the COVID-19 group and 13 patients in the control group (p≤0,156).

Conclusion. The present study demonstrates a comparable frequency of adverse outcomes of endovascular interventions in DEC in the long-term period in both patients with and without COVID-19 infection. At the same time, the frequency of late retrombosis and recurrence of DEC in patients of the control group was slightly higher (13,9 % vs. 5,8 %), and the prognosis of recurrence of DEC in the control group was worse.

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