2021
DOI: 10.1161/strokeaha.121.035613
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Cerebral Vein Thrombosis With Vaccine-Induced Immune Thrombotic Thrombocytopenia

Abstract: In the spring of 2021, reports of rare and unusual venous thrombosis in association with the ChAdOx1 and Ad26.COV2.S adenovirus-based coronavirus vaccines led to a brief suspension of their use by several countries. Thromboses in the cerebral and splanchnic veins among patients vaccinated in the preceding 4 weeks were described in 17 patients out of 7.98 million recipients of the Ad26.COV2.S vaccine (with 3 fatalities related to cerebral vein thrombosis) and 169 cases of cerebral vein thrombosis among 35 milli… Show more

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Cited by 40 publications
(38 citation statements)
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“…Possible treatment methods are high doses of intravenous immunoglobulins (IVIG), non-heparin-based anticoagulants, corticosteroid administration, and plasma exchange. After clinical stabilization, oral anticoagulants such as apixaban, rivaroxaban can be given (Iba et al 2021 ; Mohseni Afshar et al 2021 ; Siegler et al 2021 ).…”
Section: Rare Adverse Effects Of Covid-19 Vaccines (Refer To Table 9 )mentioning
confidence: 99%
“…Possible treatment methods are high doses of intravenous immunoglobulins (IVIG), non-heparin-based anticoagulants, corticosteroid administration, and plasma exchange. After clinical stabilization, oral anticoagulants such as apixaban, rivaroxaban can be given (Iba et al 2021 ; Mohseni Afshar et al 2021 ; Siegler et al 2021 ).…”
Section: Rare Adverse Effects Of Covid-19 Vaccines (Refer To Table 9 )mentioning
confidence: 99%
“…FcγRIIA, a type I transmembrane protein, can induce signaling and platelet aggregation/secretion, formation of platelet-neutrophilia and monocyte complexes, and thrombin generation [17] . As a result, platelets are activated and blood clots form [18] . The pathogenesis of VITT is similar.…”
Section: Pathogenesismentioning
confidence: 99%
“…Some refractory patients with deteriorating status may benefit from thrombectomy [18] . Aspirin should be avoided to treat or prevent VITT as it is ineffective in preventing platelet activation from anti-PF4 antibodies and may increase the risk of bleeding [30] .…”
Section: Treatmentmentioning
confidence: 99%
“…One severe side effect following vaccination with adenoviralvectored vaccines is an extremely rare syndrome called "vaccine-induced immune thrombotic thrombocytopenia" (VITT) [123]. Approximately 1:150,000 ChAdOx1 nCoV-19 recipients and 1:470,000 Ad26.COV2.S recipients have suffered from VITT, which is linked to a mortality rate of 20% to 30% [124]. Intestinal venous and arterial thromboses, cerebral venous sinus thrombosis, as well as thrombocytopenia were observed 5 to 24 days after ChAdOx1 vaccination [125,126].…”
Section: Challengesmentioning
confidence: 99%