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机械取栓治疗疫苗诱导的免疫性血栓性血小板减少症所致脑静脉窦血栓形成。

Mechanical Thrombectomy for Treatment of Cerebral Venous Sinus Thrombosis in Vaccine-Induced Immune Thrombotic Thrombocytopenia.

机构信息

Department of Neuroradiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK

Department of Neuroradiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK.

出版信息

AJNR Am J Neuroradiol. 2022 Jan;43(1):98-101. doi: 10.3174/ajnr.A7381. Epub 2021 Dec 23.

Abstract

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.

摘要

腺病毒载体 COVID-19(2019 年冠状病毒病)疫苗问世后,有报道称出现了一种罕见的伴有严重血小板减少症的脑静脉窦血栓形成。2021 年 3 月至 6 月,我院收治了 7 例难治性疫苗诱导免疫性血栓性血小板减少症患者,进行机械取栓术。1 例患者在院内转院期间病情恶化,其余 6 例患者成功再通。未报告与手术相关的不良事件。截至本文撰写时,3 例患者出院时功能恢复良好(mRS 0-1),1 例因轻度构音障碍和声带麻痹(mRS 3)需要康复,2 例因严重占位效应死亡。我们的经验表明,血管内治疗可能是安全有效的,可减少疫苗接种后脑静脉窦血栓形成患者的血栓负荷。

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