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Endovascular treatment of cerebral sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia.
Weller, Johannes; Krzywicka, Katarzyna; van de Munckhof, Anita; Dorn, Franziska; Althaus, Katharina; Bode, Felix J; Bandettini di Poggio, Monica; Buck, Brian; Kleinig, Timothy; Cordonnier, Charlotte; Dizonno, Vanessa; Duan, Jiangang; Elkady, Ahmed; Chew, Beng Lim Alvin; Garcia-Esperon, Carlos; Field, Thalia S; Legault, Catherine; Morin Martin, Mar; Michalski, Dominik; Pelz, Johann; Schoenenberger, Silvia; Nagel, Simon; Petruzzellis, Marco; Raposo, Nicolas; Skjelland, Mona; Zimatore, Domenico Sergio; Aaron, Sanjith; Sanchez van Kammen, Mayte; Aguiar de Sousa, Diana; Lindgren, Erik; Jood, Katarina; Scutelnic, Adrian; Heldner, Mirjam R; Poli, Sven; Arauz, Antonio; Conforto, Adriana B; Putaala, Jukka; Tatlisumak, Turgut; Arnold, Marcel; Coutinho, Jonathan M; Günther, Albrecht; Zimmermann, Julian; Ferro, José M.
Affiliation
  • Weller J; Department of Neurology, University Hospital Bonn, Bonn, Germany.
  • Krzywicka K; Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
  • van de Munckhof A; Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
  • Dorn F; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.
  • Althaus K; Department of Neurology, Ulm University Hospital, Ulm, Germany.
  • Bode FJ; Department of Neurology, University Hospital Bonn, Bonn, Germany.
  • Bandettini di Poggio M; Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
  • Buck B; Division of Neurology, University of Alberta Hospital, Edmonton, AB, Canada.
  • Kleinig T; Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia.
  • Cordonnier C; Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France.
  • Dizonno V; Vancouver Stroke Program, Division of Neurology, University of British Columbia, Vancouver, BC, Canada.
  • Duan J; Department of Neurology and Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China.
  • Elkady A; Department of Neurology, Saudi German Hospital, Jeddah, Saudi Arabia.
  • Chew BLA; Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia.
  • Garcia-Esperon C; Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia.
  • Field TS; Vancouver Stroke Program, Division of Neurology, University of British Columbia, Vancouver, BC, Canada.
  • Legault C; Division of Neurology, McGill University Health Centre, Montreal, QC, Canada.
  • Morin Martin M; Department of Neurology, Hospital Complex of Toledo, Toledo, Spain.
  • Michalski D; Department of Neurology, University of Leipzig, Leipzig, Germany.
  • Pelz J; Department of Neurology, University of Leipzig, Leipzig, Germany.
  • Schoenenberger S; Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
  • Nagel S; Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
  • Petruzzellis M; Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany.
  • Raposo N; Neuroradiology Unit, Azienda Ospedaliera Consorziale Policlinico di Bari, Italy.
  • Skjelland M; Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France and Inserm, Toulouse NeuroImaging Center, Université de Toulouse, Toulouse, France.
  • Zimatore DS; Department of Neurology, Oslo University Hospital, Oslo, Norway.
  • Aaron S; Neuroradiology Unit, Azienda Ospedaliera Consorziale Policlinico di Bari, Italy.
  • Sanchez van Kammen M; Neurology Unit, Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
  • Aguiar de Sousa D; Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
  • Lindgren E; CEEM and Institute of Anatomy, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
  • Jood K; Stroke Centre, Lisbon Central University Hospital, Lisbon, Portugal.
  • Scutelnic A; Department of Neurology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
  • Heldner MR; Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
  • Poli S; Department of Neurology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
  • Arauz A; Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
  • Conforto AB; Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Putaala J; Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Tatlisumak T; Department of Neurology & Stroke, Eberhard-Karls University, Tuebingen, Germany and Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tuebingen, Germany.
  • Arnold M; Instituto Nacional de Neurologia y Neurocirugia, Mexico City, Mexico.
  • Coutinho JM; Hospital das Clinicas/São Paulo University and Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Günther A; Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Zimmermann J; Department of Neurology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
  • Ferro JM; Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Eur Stroke J ; 9(1): 105-113, 2024 Mar.
Article de En | MEDLINE | ID: mdl-37771138
ABSTRACT

INTRODUCTION:

There is little data on the role of endovascular treatment (EVT) of cerebral venous sinus thrombosis (CVST) due to vaccine-induced immune thrombotic thrombocytopenia (VITT). Here, we describe clinical characteristics and outcomes of CVST-VITT patients who were treated with EVT. PATIENTS AND

METHODS:

We report data from an international registry of patients who developed CVST within 28 days of SARS-CoV-2 vaccination, reported between 29 March 2021 and 6 March 2023. VITT was defined according to the Pavord criteria.

RESULTS:

EVT was performed in 18/136 (13%) patients with CVST-VITT (92% aspiration and/or stent retrieval, 8% local thrombolysis). Most common indications were extensive thrombosis and clinical or radiological deterioration. Compared to non-EVT patients, those receiving EVT had a higher median thrombus load (4.5 vs 3). Following EVT, local blood flow was improved in 83% (10/12, 95% confidence interval [CI] 54-96). One (6%) asymptomatic sinus perforation occurred. Eight (44%) patients treated with EVT also underwent decompressive surgery. Mortality was 50% (9/18, 95% CI 29-71) and 88% (8/9, 95% CI 25-66) of surviving EVT patients achieved functional independence with a modified Rankin Scale score of 0-2 at follow-up. In multivariable analysis, EVT was not associated with increased mortality (adjusted odds ratio, 0.66, 95% CI 0.16-2.58). DISCUSSION AND

CONCLUSION:

We describe the largest cohort of CVST-VITT patients receiving EVT. Half of the patients receiving EVT died during hospital admission, but most survivors achieved functional independence.
Sujet(s)
Mots clés

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Thromboses des sinus intracrâniens / Thrombopénie / Vaccins / Purpura thrombopénique idiopathique Limites: Humans Langue: En Journal: Eur Stroke J Année: 2024 Type de document: Article Pays d'affiliation: Allemagne

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Thromboses des sinus intracrâniens / Thrombopénie / Vaccins / Purpura thrombopénique idiopathique Limites: Humans Langue: En Journal: Eur Stroke J Année: 2024 Type de document: Article Pays d'affiliation: Allemagne