Jornal Vascular Brasileiro
Jornal Vascular Brasileiro
Case Report

Alprostadil associated with low molecular weight heparin to treat limb ischemia caused by SARS-CoV2

Alprostadil associado a heparina de baixo peso molecular para o tratamento da isquemia de membros causada por SARS-CoV2

Marcos Antonio Bonacorso Manhanelli Filho; Eliud Garcia Duarte Júnior; Jamil Victor de Oliveira Mariuba; Fábio Linardi; José Augusto Costa; Julio Cesar Gali; Winston Bonetti Yoshida; Julio Cesar Gali Filho

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Abstract: The current coronavirus pandemic has already taken a great toll globally, causing massive morbidity and mortality. One of its severe forms is a thrombophilic state that can damage several systems. This article reports the case of 60-year-old female patient who presented with mild flu symptoms, which turned out to be a SARS-CoV2 infection, and ended up developing arterial thrombosis with limb ischemia in a private care hospital in Sorocaba, São Paulo, Brazil. Considering this progression, we decided to intervene with low molecular weight heparin and Alprostadil, achieving a good clinical outcome. Our description aims to identify key points and clinical signs that offer evidence of the therapeutic window and a treatment option for coagulatory presentations of COVID-19.


COVID-19, thromboembolism, limb ischemia, arterial thrombosis, heparin


Resumo: A atual pandemia de coronavírus já gerou danos profundos ao redor do mundo, causando grande quantidade de morbidades e mortes. Uma das manifestações das formas graves da doença é o estado trombofílico, que pode provocar danos em vários sistemas. Este artigo relata o caso de uma paciente do sexo feminino, 60 anos de idade, que foi internada em um serviço hospitalar privado com sintomas gripais inespecíficos leves, mas que progrediu com trombose arterial e isquemia de membros causada pelo SARS-CoV2. Devido à essa evolução, foi optada pela administração concomitante de heparina de baixo peso molecular e Alprostadil, com bom desfecho clínico. Nossa descrição objetiva identificar pontos-chave e sinais clínicos que evidenciem essa janela terapêutica, bem como uma opção de tratamento para as apresentações coagulatórias da COVID-19.


COVID-19, tromboembolismo, isquemia de membros, trombose arterial, heparina


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