Nam So Yun, Roh Hyunseok, Koo Kyunglim, Yun Woo Sung, Kim Hyun Chul
Aeromedical Evacuation Unit, Army Aviation Command, Republic of Korea Army, Seongnam, Korea.
Division of Vascular Surgery, Department of Surgery, Armed Forces Capital Hospital, Seongnam, Korea.
Vasc Specialist Int. 2022 Dec 30;38:40. doi: 10.5758/vsi.220045.
Severe side effects of adenoviral-vectored-DNA COVID-19 vaccines such as thrombosis have been reported. Herein, we report a case of sudden massive deep vein thrombosis (DVT) in a young man with inferior vena cava anomaly 20 hours after the second dose of the mRNA vaccine for COVID-19. There was recurrence of iliofemoral DVT after one year, despite complete resolution and administration of prophylactic anticoagulants. We suggest that the sudden episode was triggered by the vaccine rather than the venous anomaly, which can be associated with recurrence due to inadequate venous return through the small and tortuous infrarenal veins or increased venous pressure and stasis. There are no standard guidelines for the management of DVT following mRNA vaccination. However, we highlight the importance of initial workups, regular follow-ups, and standard treatment options, including the continuous administration of prophylactic anticoagulants which should be considered to prevent recurrence.
已报告腺病毒载体DNA新冠疫苗的严重副作用，如血栓形成。在此，我们报告一例年轻男性在接种第二剂新冠mRNA疫苗20小时后，因下腔静脉异常出现突发性大量深静脉血栓形成（DVT）的病例。尽管血栓已完全消退且给予了预防性抗凝治疗，但一年后髂股静脉血栓再次复发。我们认为，突发性发作是由疫苗引发的，而非静脉异常，静脉异常可能因通过小而迂曲的肾下静脉的静脉回流不足或静脉压力增加及血液淤滞而导致复发。对于mRNA疫苗接种后DVT的管理，目前尚无标准指南。然而，我们强调了初始检查、定期随访以及标准治疗方案的重要性，包括持续给予预防性抗凝治疗，应考虑采用该治疗来预防复发。
