Persistent hypercoagulability and acute limb ischemia post COVID-19

Natalia Penaloza; Emmanuel C. Ebirim; Annie Cherner; Channa Blakely; Christine Shokrzadeh; Mitchell Cox

doi:10.1016/j.jvscit.2025.101953

Persistent hypercoagulability and acute limb ischemia post COVID-19

Natalia Penaloza
, Emmanuel C. Ebirim
, Annie Cherner
, Channa Blakely
, Christine Shokrzadeh
, Mitchell Cox

Surgery

Research output: Contribution to journal › Article › peer-review

Abstract

Research indicates that COVID-19 induces endotheliitis, hypercoagulation, and hypofibrinolysis owing to virus-induced endothelial dysfunction. We present a case of a 34-year-old man with acute limb ischemia 4 days after COVID-19 diagnosis. Arterial duplex ultrasound examination revealed acute thrombosis of the popliteal artery and systemic anticoagulation was started. Despite multiple successful embolectomies and aggressive anticoagulant therapy, rethrombosis occurred, requiring bypass surgery approximately 1 year later. This case highlights the prolonged hypercoagulability post COVID-19 infection and the need for ongoing monitoring and tailored thromboprophylaxis to manage complications, especially with the evolving understanding of COVID-19-related hypercoagulability.

Original language	English (US)
Article number	101953
Journal	Journal of Vascular Surgery Cases, Innovations and Techniques
Volume	11
Issue number	6
DOIs	https://doi.org/10.1016/j.jvscit.2025.101953
State	Published - Dec 2025

Keywords

Case report
COVID-19
Hypercoagulability
Thrombosis

ASJC Scopus subject areas

Surgery
Cardiology and Cardiovascular Medicine

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10.1016/j.jvscit.2025.101953

Cite this

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title = "Persistent hypercoagulability and acute limb ischemia post COVID-19",

abstract = "Research indicates that COVID-19 induces endotheliitis, hypercoagulation, and hypofibrinolysis owing to virus-induced endothelial dysfunction. We present a case of a 34-year-old man with acute limb ischemia 4 days after COVID-19 diagnosis. Arterial duplex ultrasound examination revealed acute thrombosis of the popliteal artery and systemic anticoagulation was started. Despite multiple successful embolectomies and aggressive anticoagulant therapy, rethrombosis occurred, requiring bypass surgery approximately 1 year later. This case highlights the prolonged hypercoagulability post COVID-19 infection and the need for ongoing monitoring and tailored thromboprophylaxis to manage complications, especially with the evolving understanding of COVID-19-related hypercoagulability.",

keywords = "Case report, COVID-19, Hypercoagulability, Thrombosis",

author = "Natalia Penaloza and Ebirim, \{Emmanuel C.\} and Annie Cherner and Channa Blakely and Christine Shokrzadeh and Mitchell Cox",

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language = "English (US)",

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publisher = "Society for Vascular Surgery",

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TY - JOUR

T1 - Persistent hypercoagulability and acute limb ischemia post COVID-19

AU - Penaloza, Natalia

AU - Ebirim, Emmanuel C.

AU - Cherner, Annie

AU - Blakely, Channa

AU - Shokrzadeh, Christine

AU - Cox, Mitchell

PY - 2025/12

Y1 - 2025/12

N2 - Research indicates that COVID-19 induces endotheliitis, hypercoagulation, and hypofibrinolysis owing to virus-induced endothelial dysfunction. We present a case of a 34-year-old man with acute limb ischemia 4 days after COVID-19 diagnosis. Arterial duplex ultrasound examination revealed acute thrombosis of the popliteal artery and systemic anticoagulation was started. Despite multiple successful embolectomies and aggressive anticoagulant therapy, rethrombosis occurred, requiring bypass surgery approximately 1 year later. This case highlights the prolonged hypercoagulability post COVID-19 infection and the need for ongoing monitoring and tailored thromboprophylaxis to manage complications, especially with the evolving understanding of COVID-19-related hypercoagulability.

AB - Research indicates that COVID-19 induces endotheliitis, hypercoagulation, and hypofibrinolysis owing to virus-induced endothelial dysfunction. We present a case of a 34-year-old man with acute limb ischemia 4 days after COVID-19 diagnosis. Arterial duplex ultrasound examination revealed acute thrombosis of the popliteal artery and systemic anticoagulation was started. Despite multiple successful embolectomies and aggressive anticoagulant therapy, rethrombosis occurred, requiring bypass surgery approximately 1 year later. This case highlights the prolonged hypercoagulability post COVID-19 infection and the need for ongoing monitoring and tailored thromboprophylaxis to manage complications, especially with the evolving understanding of COVID-19-related hypercoagulability.

KW - Case report

KW - COVID-19

KW - Hypercoagulability

KW - Thrombosis

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M3 - Article

AN - SCOPUS:105015494317

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JO - Journal of Vascular Surgery Cases, Innovations and Techniques

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ER -

Persistent hypercoagulability and acute limb ischemia post COVID-19

Abstract

Keywords

ASJC Scopus subject areas

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