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本文引用的文献

1
Clinical Features of Vaccine-Induced Immune Thrombocytopenia and Thrombosis.疫苗诱导的免疫性血小板减少症和血栓形成的临床特征。
N Engl J Med. 2021 Oct 28;385(18):1680-1689. doi: 10.1056/NEJMoa2109908. Epub 2021 Aug 11.
2
Post-SARS-CoV-2-vaccination cerebral venous sinus thrombosis: an analysis of cases notified to the European Medicines Agency.接种 SARS-CoV-2 疫苗后的脑静脉窦血栓形成:向欧洲药品管理局报告的病例分析。
Eur J Neurol. 2021 Nov;28(11):3656-3662. doi: 10.1111/ene.15029. Epub 2021 Aug 4.
3
COVID-19 Vaccine-Associated Cerebral Venous Thrombosis in Germany.德国的 COVID-19 疫苗相关的脑静脉血栓。
Ann Neurol. 2021 Oct;90(4):627-639. doi: 10.1002/ana.26172. Epub 2021 Aug 23.
4
Vaccine-induced Immune Thrombocytopenia and Thrombosis (VITT).疫苗诱导的免疫性血小板减少症和血栓形成(VITT)
Res Pract Thromb Haemost. 2021 Jun 1;5(5):e12529. doi: 10.1002/rth2.12529. eCollection 2021 Jun.
5
US Case Reports of Cerebral Venous Sinus Thrombosis With Thrombocytopenia After Ad26.COV2.S Vaccination, March 2 to April 21, 2021.美国 2021 年 3 月 2 日至 4 月 21 日 Ad26.COV2.S 疫苗接种后出现脑静脉窦血栓形成伴血小板减少的病例报告。
JAMA. 2021 Jun 22;325(24):2448-2456. doi: 10.1001/jama.2021.7517.
6
Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination.接种 ChAdOx1 nCov-19 疫苗后发生血栓性血小板减少症。
N Engl J Med. 2021 Jun 3;384(22):2092-2101. doi: 10.1056/NEJMoa2104840. Epub 2021 Apr 9.
7
Effect of Endovascular Treatment With Medical Management vs Standard Care on Severe Cerebral Venous Thrombosis: The TO-ACT Randomized Clinical Trial.血管内治疗联合药物治疗与标准治疗对重症颅内静脉血栓形成的影响:TO-ACT 随机临床试验。
JAMA Neurol. 2020 Aug 1;77(8):966-973. doi: 10.1001/jamaneurol.2020.1022.
8
European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology.欧洲卒中组织脑静脉血栓形成诊断与治疗指南- 欧洲神经病学学会认可。
Eur J Neurol. 2017 Oct;24(10):1203-1213. doi: 10.1111/ene.13381. Epub 2017 Aug 20.
9
Endovascular mechanical thrombectomy for cerebral venous sinus thrombosis: a systematic review.血管内机械取栓治疗脑静脉窦血栓形成:一项系统评价。
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10
Mechanical thrombectomy in cerebral venous thrombosis: systematic review of 185 cases.大脑静脉血栓形成的机械取栓术:185例系统评价
Stroke. 2015 May;46(5):1263-8. doi: 10.1161/STROKEAHA.114.007465. Epub 2015 Apr 21.

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.

DOI:10.3174/ajnr.A7381
PMID:34949591
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8757551/
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。