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Acute Ischemic Stroke Revealing ChAdOx1 nCov-19 Vaccine-Induced Immune Thrombotic Thrombocytopenia: Impact on Recanalization Strategy.
Costentin, Guillaume; Ozkul-Wermester, Ozlem; Triquenot, Aude; Cam-Duchez, Véronique Le; Massy, Nathalie; Benhamou, Ygal; Massardier, Evelyne.
  • Costentin G; Department of Neurology, Rouen University Hospital, Rouen F-76000, France. Electronic address: guillaume.costentin@chu-rouen.fr.
  • Ozkul-Wermester O; Department of Neurology, Rouen University Hospital, Rouen F-76000, France.
  • Triquenot A; Department of Neurology, Rouen University Hospital, Rouen F-76000, France.
  • Cam-Duchez VL; Rouen University Hospital, Vascular Hemostasis Unit, Normandie University, UNIROUEN, INSERM U1096, Rouen F76031, France.
  • Massy N; Department of Pharmacovigilance, Rouen University Hospital, Rouen F-76000, France.
  • Benhamou Y; Department of Internal Medicine, Rouen University Hospital, Rouen F-76000, France.
  • Massardier E; Department of Neurology, Rouen University Hospital, Rouen F-76000, France.
J Stroke Cerebrovasc Dis ; 30(9): 105942, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1281474
ABSTRACT
Vaccine-induced immune thrombotic thrombocytopenia is a rare syndrome following the ChAdOx1 nCov-19 or Ad26.COV2.S vaccine. Reported patients developed mainly venous thrombosis. We describe a case of a young healthy women suffering from acute ischemic stroke due to large vessel occlusion without cerebral venous thrombosis 8 days after vaccination and its consequences on recanalization strategy. Considering the thrombocytopenia, intravenous thrombolysis was contraindicated. She underwent mechanical thrombectomy with complete recanalization and dramatically improved clinically. Positive detection of anti-PF4-heparin-antibodies confirmed vaccine-induced immune thrombotic thrombocytopenia diagnosis. In case of acute ischemic stroke after recent ChAdOx1 nCov-19 or Ad26.COV2.S vaccine, platelet count should be systematically checked before giving thrombolysis, and direct mechanical thrombectomy should be proposed in patients with large vessel occlusion.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Purpura, Thrombotic Thrombocytopenic / Vaccination / Thrombectomy / Ischemic Stroke / COVID-19 Vaccines Type of study: Case report / Diagnostic study / Experimental Studies / Prognostic study Topics: Vaccines Limits: Adult / Female / Humans Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Purpura, Thrombotic Thrombocytopenic / Vaccination / Thrombectomy / Ischemic Stroke / COVID-19 Vaccines Type of study: Case report / Diagnostic study / Experimental Studies / Prognostic study Topics: Vaccines Limits: Adult / Female / Humans Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2021 Document Type: Article