Mechanical Thrombectomy for Treatment of Cerebral Venous Sinus Thrombosis in Vaccine-Induced Immune Thrombotic Thrombocytopenia.
Han Seng ChewSamer Al-AliBenjamin ButlerDilina RajapakseK NaderSwarupsinh ChavdaSaleh LaminPublished in: AJNR. American journal of neuroradiology (2021)
Reports of a rare form of cerebral venous sinus thrombosis with profound thrombocytopenia have emerged following introduction of the adenovirus-vectored coronavirus disease 2019 (COVID-19) vaccines. Between March and June 2021, seven cases of refractory vaccine-induced immune thrombotic thrombocytopenia were referred to our institution for mechanical thrombectomy. The condition of 1 patient deteriorated during interhospital transfer, and the remaining 6 underwent successful recanalization. No procedure-related adverse events were reported. At the time of this writing, 3 patients have been discharged with a good functional outcome (mRS 0-1), one required rehabilitation for mild dysarthria and vocal cord palsy (mRS 3), and 2 have died due to severe mass effect. Our anecdotal experience suggests that endovascular therapy may be safe and effective in reducing thrombus burden in selected cases of postvaccination cerebral venous sinus thrombosis.
Keyphrases
- coronavirus disease
- pulmonary embolism
- subarachnoid hemorrhage
- end stage renal disease
- high glucose
- diabetic rats
- drug induced
- ejection fraction
- newly diagnosed
- chronic kidney disease
- sars cov
- cerebral ischemia
- case report
- peritoneal dialysis
- respiratory syndrome coronavirus
- brain injury
- emergency department
- patient reported outcomes
- mesenchymal stem cells
- intellectual disability
- cerebral blood flow
- oxidative stress
- blood brain barrier
- gene therapy
- cell therapy
- smoking cessation