Title
Outcomes of Cerebral Venous Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia After the Acute Phase.
Link to article in PubMed
Author(s)
van de Munckhof A
Lindgren E
Kleinig TJ
Field TS
Cordonnier C
Krzywicka K
Poli S
Sánchez van Kammen M
Borhani-Haghighi A
Lemmens R
Scutelnic A
Ciccone A
Gattringer T
Wittstock M
Dizonno V
Devroye A
Elkady A
Günther A
Mengel A
Chew BLA
Buck B
Zanferrari C
Garcia-Esperon C
Jacobi C
Soriano C
Michalski D
Zamani Z
Blacquiere D
Johansson E
Cuadrado-Godia E
Vuillier F
Bode FJ
Caparros F
Maier F
Tsivgoulis G
Katzberg HD
Duan J
Pelz J
Mbroh J
Oen J
Schouten J
Zimmermann J
Ng K
Garambois K
Petruzzellis M
Carvalho Dias M
Ghiasian M
Romoli M
Miranda M
Wronski M
Skjelland M
Almasi-Dooghaee M
Cuisenier P
Murphy S
Timsit S
Coutts SB
Schönenberger S
Nagel S
Hiltunen S
Chatterton S
Cox T
Bartsch T
Shaygannejad V
Mirzaasgari Z
Middeldorp S
Levi MM
Kremer Hovinga JA
Jood K
Tatlisumak T
Putaala J
Heldner MR
Arnold M
Aguiar de Sousa D
Ferro JM
Coutinho JM
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.
Publication information
Stroke. 2022 Sep 9:101161STROKEAHA122039575. doi: 10.1161/STROKEAHA.122.039575.
Date Issued
2022-09-09
Type
Journal Article
Journal Title
Stroke
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