Docs go out on a limb to save patient’s hand

ARTERIAL THROMBOSIS: Rare complication manifests in second wave; five similar cases treated at SevenHills Hospital in recent weeks

Doctors at the civic-run SevenHills Hospital in Marol had to perform an emergency procedure on a 42year-old Covid patient recently, to save his left hand from gangrene and possible amputation. What the patient had was arterial thrombosis, a rare Covid-19 complication. Doctors at the facility say they have operated on at least five such cases in the last one month. This was something not seen in the first wave of the pandemic, doctors say and now, every patient with such symptoms is being closely monitored, to enable timely intervention.

Thrombosis is the formation of blood clots in the artery (arterial thrombosis) or vein (venous thrombosis). Once formed, a clot can slow or block normal blood flow and even break loose and travel to an organ.

Dr Ganesh Manudhane, head of cardiology, SHH, said a 42-year-old Covid patient was referred to them with discolouration in three of his fingers. To the doctors, it looked like a case of arterial thrombosis. Interestingly, the patient was asymptomatic but had tested Covid-positive and had developed arterial thrombosis, which had them concerned, as they were aware that it was a rare Covid complication.

“The patient had been admitted to the BKC Jumbo Centre last month, following which the fingers of his left-hand fingers had turned blue.

Later, he was shifted to SevenHills for treatment. He didn’t have a fever or cough but had this discolouration in three fingers and we needed to act immediately, to save his hand,” Dr Manudhane said.

Eventually, a peripheral angiography revealed that of the two arteries in his left hand, one had a partial blockage while the other had a complete blockage, which could have led to an acute circulatory cut-off of oxygen in the limb, thereby increasing the risk of gangrene.

“An interventional procedure called thrombo-suction thrombectomy was performed to extract all the blood clots by inserting a catheter from his right thigh region to his left hand. Following which, he was kept on a thrombolytic drug for 24 hours, which helped to dissolve the remaining clots,” he explained.

Dr Maharudra Kumbhar, who is in charge of SevenHills, said they had treated five such patients in the last one month and timely intervention had helped them save all patients. “There are many complications associated with Covid patients, such as a stroke (clot in the cerebral artery), clots in the lungs, heart attack, deep vein thrombosis, and thrombosis in both the upper and lower limb arteries,” he said.