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The Journal of Cardiovascular Surgery 2021 Sep 28

DOI: 10.23736/S0021-9509.21.12021-X

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

COVID-19 and supra-aortic trunks disease: review of literature about critical phase and sequelae

Renato CASANA 1, 2 , Maurizio DOMANIN 3, 4, Silvia ROMAGNOLI 4, Daniele BISSACCO 4, Chiara MALLOGGI 2, Viviana GRASSI 4, Vincenzo SILANI 5, 6, Gianfranco PARATI 7, 8, Marc L. SCHERMERHORN 9, Santi TRIMARCHI 3, 4

1 Department of Surgery, Istituto Auxologico Italiano, IRCCS, Milan, Italy; 2 Laboratory of Research in Vascular Surgery, Istituto Auxologico Italiano, IRCCS, Milan, Italy; 3 Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy; 4 Vascular Surgery Unit, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; 5 Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milan, Italy; 6 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; 7 Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, Milan, Italy; 8 Department of Medicine and Surgery, Università di Milano-Bicocca, Monza, Italy; 9 Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA


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The acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the COVID-19 disease, a global pandemic. A strong association has been documented between COVID-19 and cardiovascular events, although the exact pathophysiological mechanism is still unclear. Carotid atherothrombosis and ischemic stroke represents one of the possible severe manifestations of COVID-19, as a leading cause of long-term disability and death. Different complex intertwined mechanisms seem to underlie the endothelitis which is the cause of multiple cardiovascular manifestations. To date, few case series describing COVID-19 and acute ischemic stroke caused by cervical carotid thrombosis have been published. All the patients shared common similar radiographic features, comorbidities, and biomarker profiles. The aim of this brief review is to analyze the impact of COVID-19 pandemic in the management of a Vascular Surgery Department, changing the daily vascular practice, as well as to provide practical suggestions for symptomatic carotid stenosis, while reviewing published literature.


KEY WORDS: COVID-19; Carotid disease; Vascular surgery; Ischemic stroke; SARS-CoV-2

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