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Outcomes of Cerebral Venous Thrombosis Due to Vaccine-Induced Immune Thrombotic Thrombocytopenia After the Acute Phase Publisher Pubmed



Van De Munckhof A1 ; Lindgren E3, 4 ; Kleinig TJ5 ; Field TS6 ; Cordonnier C7 ; Krzywicka K1 ; Poli S8, 9 ; Sanchez Van Kammen M1 ; Borhanihaghighi A10 ; Lemmens R11 ; Scutelnic A12 ; Ciccone A14 ; Gattringer T15 ; Wittstock M16 Show All Authors
Authors
  1. Van De Munckhof A1
  2. Lindgren E3, 4
  3. Kleinig TJ5
  4. Field TS6
  5. Cordonnier C7
  6. Krzywicka K1
  7. Poli S8, 9
  8. Sanchez Van Kammen M1
  9. Borhanihaghighi A10
  10. Lemmens R11
  11. Scutelnic A12
  12. Ciccone A14
  13. Gattringer T15
  14. Wittstock M16
  15. Dizonno V6
  16. Devroye A11
  17. Elkady A17
  18. Gunther A18
  19. Cervera A19
  20. Mengel A8
  21. Chew BLA20
  22. Buck B21
  23. Zanferrari C22
  24. Garciaesperon C20
  25. Jacobi C23
  26. Soriano C24
  27. Michalski D25
  28. Zamani Z26
  29. Blacquiere D28
  30. Johansson E29
  31. Cuadradogodia E30
  32. Vuillier F31
  33. Bode FJ32
  34. Caparros F7
  35. Maier F33
  36. Tsivgoulis G34
  37. Katzberg HD35
  38. Duan J36
  39. Burrow J37
  40. Pelz J25
  41. Mbroh J8, 9
  42. Oen J38
  43. Schouten J39
  44. Zimmermann J32
  45. Ng K40
  46. Garambois K41
  47. Petruzzellis M42
  48. Carvalho Dias M43
  49. Ghiasian M44
  50. Romoli M45
  51. Miranda M46
  52. Wronski M40
  53. Skjelland M47
  54. Almasidooghaee M27
  55. Cuisenier P41
  56. Murphy S48
  57. Timsit S49
  58. Coutts SB50
  59. Schonenberger S51
  60. Nagel S51
  61. Hiltunen S52
  62. Chatterton S40
  63. Cox T53
  64. Bartsch T54
  65. Shaygannejad V55, 56
  66. Mirzaasgari Z27
  67. Middeldorp S57
  68. Levi MM2, 58
  69. Kremer Hovinga JA13
  70. Jood K3, 4
  71. Tatlisumak T4, 52
  72. Putaala J42
  73. Heldner MR12
  74. Arnold M12
  75. Aguiar De Sousa D59, 60
  76. Ferro JM60
  77. Coutinho JM1

Source: Stroke Published:2022


Abstract

Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0-2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94-194). Two patients died during follow-up (3% [95% CI, 1%-11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%-94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). Conclusions: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up. © 2022 Lippincott Williams and Wilkins. All rights reserved.
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