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Abstract：
UNASSIGNED: Venous thrombosis has been widely described in the setting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, arterial thrombosis has rarely been reported. This study aims to assess the incidence, risk factors, interventions, and outcomes of acute aortoiliac arterial thrombosis in patients with active SARS-CoV-2 infections.
UNASSIGNED: We present seven SARS-CoV-2-positive patients from our institution who acutely developed thrombi in the aortoiliac arterial system (7/2020-1/2021). A systematic review of the literature on aortoiliac arterial thrombosis in patients with SARS-CoV-2 infections in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was also performed. The available data from all reported cases in the literature and at our institution were analyzed.
UNASSIGNED: Thirty published articles and journal correspondences, including 52 patients, were reviewed and analyzed in addition to our institution\'s 7 cases. In total, 59 SARS-CoV-2-positive patients were found to have acute aortoiliac thrombosis. The abdominal aorta was the most frequent location for the development of a thrombus. Baseline demographics and medical comorbidities were not significantly different between the symptomatic and asymptomatic cohorts. Seventy-one percent of patients were symptomatic (lower limb ischemia: 75.0%, renal infarction: 20.0%, stroke: 12.5%, mesenteric ischemia: 10.0%). All patients with thrombus involving the ascending aorta, aortic bifurcation, or iliac artery developed thromboembolic or ischemic complications. All patients received systemic anticoagulation. Fifty-three percent of all patients were managed medically. Ninety-four percent of the asymptomatic patients were managed medically. One asymptomatic patient underwent endovascular aspiration of a mobile thrombus. Three (23.1%) deaths occurred in the asymptomatic cohort from hypoxic respiratory failure. Fourteen (36.8%) deaths occurred in the symptomatic cohort. The in-hospital mortality rate was 33.3% overall and 43.8% for patients with thrombi involving more than one aortoiliac segment.
UNASSIGNED: The presence of thrombi in the aortoiliac arterial system appears to be a poor prognostic indicator for patients with active SARS-CoV-2 infections. Medical management of patients with asymptomatic aortoiliac thrombi may be considered. The presence of thrombi involving the ascending aorta, aortic bifurcation, or iliac artery may warrant consideration for operative intervention due to the risk for thromboembolic or ischemic complications. Further study is needed to fully delineate the risk factors, optimal treatment, and outcomes of arterial thrombosis in the setting of SARS-CoV-2 infection.
UNASSIGNED: We present seven SARS-CoV-2-positive patients from our institution who acutely developed thrombi in the aortoiliac arterial system (7/2020-1/2021). A systematic review of the literature on aortoiliac arterial thrombosis in patients with SARS-CoV-2 infections in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was also performed. The available data from all reported cases in the literature and at our institution were analyzed.
UNASSIGNED: Thirty published articles and journal correspondences, including 52 patients, were reviewed and analyzed in addition to our institution\'s 7 cases. In total, 59 SARS-CoV-2-positive patients were found to have acute aortoiliac thrombosis. The abdominal aorta was the most frequent location for the development of a thrombus. Baseline demographics and medical comorbidities were not significantly different between the symptomatic and asymptomatic cohorts. Seventy-one percent of patients were symptomatic (lower limb ischemia: 75.0%, renal infarction: 20.0%, stroke: 12.5%, mesenteric ischemia: 10.0%). All patients with thrombus involving the ascending aorta, aortic bifurcation, or iliac artery developed thromboembolic or ischemic complications. All patients received systemic anticoagulation. Fifty-three percent of all patients were managed medically. Ninety-four percent of the asymptomatic patients were managed medically. One asymptomatic patient underwent endovascular aspiration of a mobile thrombus. Three (23.1%) deaths occurred in the asymptomatic cohort from hypoxic respiratory failure. Fourteen (36.8%) deaths occurred in the symptomatic cohort. The in-hospital mortality rate was 33.3% overall and 43.8% for patients with thrombi involving more than one aortoiliac segment.
UNASSIGNED: The presence of thrombi in the aortoiliac arterial system appears to be a poor prognostic indicator for patients with active SARS-CoV-2 infections. Medical management of patients with asymptomatic aortoiliac thrombi may be considered. The presence of thrombi involving the ascending aorta, aortic bifurcation, or iliac artery may warrant consideration for operative intervention due to the risk for thromboembolic or ischemic complications. Further study is needed to fully delineate the risk factors, optimal treatment, and outcomes of arterial thrombosis in the setting of SARS-CoV-2 infection.
摘要：
■在严重急性呼吸道综合症冠状病毒2（SARS-CoV-2）感染的背景下，静脉血栓形成已被广泛描述；但是，动脉血栓形成的报道很少。这项研究旨在评估发病率，危险因素，干预措施，SARS-CoV-2活动性感染患者急性主髂动脉血栓形成的结局。
■我们介绍了来自我们机构的7名SARS-CoV-2阳性患者，他们在主动脉动脉系统中急性发展了血栓（7/2020-1/2021）。还根据系统评价和荟萃分析指南的首选报告项目，对SARS-CoV-2感染患者的主动脉动脉血栓形成的文献进行了系统回顾。分析了文献和我们机构中所有报告病例的可用数据。
■30篇发表的文章和期刊通讯，包括52名患者,除了我们机构的7例病例外，还进行了审查和分析。总的来说,59例SARS-CoV-2阳性患者被发现患有急性主髂动脉血栓形成。腹主动脉是血栓形成的最常见位置。基线人口统计学和医学合并症在有症状和无症状队列之间没有显着差异。71％的患者有症状（下肢缺血：75.0％，肾梗死：20.0%，中风：12.5％，肠系膜缺血：10.0%）。所有血栓累及升主动脉的患者,主动脉分叉,或髂动脉出现血栓栓塞或缺血并发症。所有患者均接受全身抗凝治疗。所有患者中有53％接受了医学管理。94％的无症状患者接受了医学治疗。一名无症状患者接受了血管内移动血栓抽吸术。无症状队列中有3例（23.1％）死于低氧性呼吸衰竭。有症状队列中有14例(36.8%)死亡。对于涉及一个以上主动脉段的血栓患者，院内死亡率为33.3％，为43.8％。
■对于患有活动性SARS-CoV-2感染的患者，主动脉动脉系统中血栓的存在似乎是一个不良的预后指标。可以考虑对无症状的主髂动脉血栓患者进行医疗处理。出现累及升主动脉的血栓,主动脉分叉,由于血栓栓塞或缺血性并发症的风险,髂动脉可能需要考虑手术干预.需要进一步的研究来充分描述风险因素，最佳治疗,SARS-CoV-2感染背景下动脉血栓形成的结果。
■我们介绍了来自我们机构的7名SARS-CoV-2阳性患者，他们在主动脉动脉系统中急性发展了血栓（7/2020-1/2021）。还根据系统评价和荟萃分析指南的首选报告项目，对SARS-CoV-2感染患者的主动脉动脉血栓形成的文献进行了系统回顾。分析了文献和我们机构中所有报告病例的可用数据。
■30篇发表的文章和期刊通讯，包括52名患者,除了我们机构的7例病例外，还进行了审查和分析。总的来说,59例SARS-CoV-2阳性患者被发现患有急性主髂动脉血栓形成。腹主动脉是血栓形成的最常见位置。基线人口统计学和医学合并症在有症状和无症状队列之间没有显着差异。71％的患者有症状（下肢缺血：75.0％，肾梗死：20.0%，中风：12.5％，肠系膜缺血：10.0%）。所有血栓累及升主动脉的患者,主动脉分叉,或髂动脉出现血栓栓塞或缺血并发症。所有患者均接受全身抗凝治疗。所有患者中有53％接受了医学管理。94％的无症状患者接受了医学治疗。一名无症状患者接受了血管内移动血栓抽吸术。无症状队列中有3例（23.1％）死于低氧性呼吸衰竭。有症状队列中有14例(36.8%)死亡。对于涉及一个以上主动脉段的血栓患者，院内死亡率为33.3％，为43.8％。
■对于患有活动性SARS-CoV-2感染的患者，主动脉动脉系统中血栓的存在似乎是一个不良的预后指标。可以考虑对无症状的主髂动脉血栓患者进行医疗处理。出现累及升主动脉的血栓,主动脉分叉,由于血栓栓塞或缺血性并发症的风险,髂动脉可能需要考虑手术干预.需要进一步的研究来充分描述风险因素，最佳治疗,SARS-CoV-2感染背景下动脉血栓形成的结果。
