Acute ischemic stroke due to floating thrombus of ascending aorta: An acute and subacute complication of SARS-CoV-2 infection

Manna, Nunzio Davide de; Bax, Francesco; Sponga, Sandro; Toso, Francesco; Valente, Mariarosaria; D’Agostini, Serena; Vendramin, Igor; Lechiancole, Andrea; Pompei, Esmeralda; Gigli, Gian Luigi; Livi, Ugolino

doi:10.1016/j.nerep.2022.100127

Cited by 2 publications

(1 citation statement)

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“…Taken together, these data substantiate the concept that mild carotid atherosclerotic plaque may be susceptible to thrombus formation in the context of COVID-19-related immunothrombosis, potentially resulting in CFFT. Additionally, aortic arch mobile thrombi have been recurrently observed in COVID-19 patients with stroke, reinforcing the concept of a prothrombotic state as the underlying etiology [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 92%

Carotid free-floating thrombus in COVID-19: a cerebrovascular disorder of cytokine storm-related immunothrombosis

et al. 2023

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Backgrounds Several neurological manifestations, including stroke, have been reported in COVID-19 patients. The putative role of the COVID-19-related hyperinflammatory state in cerebrovascular disorders remains unclear. Methods From March 2020 to September 2021, we searched for patients who exhibited an ischemic stroke related to carotid free-floating thrombus (CFFT) to investigate its incidence and relationship with COVID-19. Results Of 853 ischemic strokes referred to our Stroke Centre during the study period, 5.7% ( n = 49) were positive for SARS-CoV-2. Six had CFFT, of which two tested positive for SARS-CoV-2 (2/49 = 4.1%), and four did not (4/802 = 0.5%). The former were two middle-aged men suffering from COVID-19 pneumonia. Floating thrombi were promptly extracted by endarterectomy and endovascular thrombectomy, respectively, with no early and long-term complications. Notably, our COVID-19 patients exhibited little or no atherosclerosis burden on CT angiography, markedly elevated D-dimer levels, and extensive thrombus length. Conclusions COVID-19-induced immunothrombosis possibly played a significant pathogenic role in CFFT. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-023-06682-3.

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Section: Discussionmentioning

confidence: 92%