tetano
Editor, Senior Moderator
Acta Chir Belg
. 2021 Dec 10;1-12.
Online ahead of print.
Aortic thrombosis and acute limb ischemia after ChAdOx1 nCov-19 (Oxford-AstraZeneca) vaccination: a case of vaccine-induced thrombocytopenia and thrombosis (VITT)
Maaike Vierstraete[SUP] 1 [/SUP], Toon Sabbe[SUP] 1 [/SUP]
Affiliations
Abstract
IntroductionVaccine-induced thrombocytopenia and thrombosis (VITT) is a rare but devastating adverse event associated with the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) adenoviral vaccine against the Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2).MethodsA 49-year-old man presented to the emergency department with acute right limb ischemia (Rutherford IIB) nine days after his ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccination. CT angiography revealed significant aortic thrombosis and right femoral artery occlusion. Severe thrombocytopenia (platelet count of 23 x10[SUP]3[/SUP]/μL), promptly elevated D-dimers (37937 ng/mL) and a reduced fibrinogen level (176 mg/dL) were remarkable. ELISA testing for anti-PF4 antibodies confirmed the diagnosis of VITT.ResultsAn emergency revascularization of the right leg was provided via thrombectomy. High-dose intravenous immunoglobulins were administered whereafter the platelet count restored gradually. Therapeutic anticoagulation was progressively started. The postoperative course was uneventful and follow-up imaging after 4 weeks showed an almost complete resolution of the significant aortic thrombosis.ConclusionEarly recognition and appropriate counseling of VITT is advocated to pursue a good clinical outcome. Our patient presenting with severe aortic thrombosis and acute limb ischemia was successfully treated by a vascular thrombectomy along with intravenous immunoglobulins and anticoagulation therapy as the mainstay therapy.
Keywords: ChAdOx1 nCov-19 (Oxford-AstraZeneca); Coronavirus Disease 2019 (COVID-19); Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2); Vaccine-Induced Thrombocytopenia and Thrombosis (VITT).
. 2021 Dec 10;1-12.
Online ahead of print.
Aortic thrombosis and acute limb ischemia after ChAdOx1 nCov-19 (Oxford-AstraZeneca) vaccination: a case of vaccine-induced thrombocytopenia and thrombosis (VITT)
Maaike Vierstraete[SUP] 1 [/SUP], Toon Sabbe[SUP] 1 [/SUP]
Affiliations
- PMID: 34890294
Abstract
IntroductionVaccine-induced thrombocytopenia and thrombosis (VITT) is a rare but devastating adverse event associated with the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) adenoviral vaccine against the Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2).MethodsA 49-year-old man presented to the emergency department with acute right limb ischemia (Rutherford IIB) nine days after his ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccination. CT angiography revealed significant aortic thrombosis and right femoral artery occlusion. Severe thrombocytopenia (platelet count of 23 x10[SUP]3[/SUP]/μL), promptly elevated D-dimers (37937 ng/mL) and a reduced fibrinogen level (176 mg/dL) were remarkable. ELISA testing for anti-PF4 antibodies confirmed the diagnosis of VITT.ResultsAn emergency revascularization of the right leg was provided via thrombectomy. High-dose intravenous immunoglobulins were administered whereafter the platelet count restored gradually. Therapeutic anticoagulation was progressively started. The postoperative course was uneventful and follow-up imaging after 4 weeks showed an almost complete resolution of the significant aortic thrombosis.ConclusionEarly recognition and appropriate counseling of VITT is advocated to pursue a good clinical outcome. Our patient presenting with severe aortic thrombosis and acute limb ischemia was successfully treated by a vascular thrombectomy along with intravenous immunoglobulins and anticoagulation therapy as the mainstay therapy.
Keywords: ChAdOx1 nCov-19 (Oxford-AstraZeneca); Coronavirus Disease 2019 (COVID-19); Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2); Vaccine-Induced Thrombocytopenia and Thrombosis (VITT).