Thrombosis and Thrombocytopenia Syndrome Causing Isolated Symptomatic Carotid Occlusion after Covid-19 Vaccine

Introduction

Thrombosis with thrombocytopenia syndrome (TTS) is a rare adverse event described after vaccination against COVID-19, mainly with nonreplicant adenovirus vector-based vaccines. As of September 9, 2021, reported cases of TTS in Europe and United States account for 8.5 per million doses with ChAdOx1 nCov-19 (AstraZeneca), 3.1 with Ad26.COV2.S (Janssen/Johnson&Johnson), 0.4 with BNT162b2 (Pfizer/BioNtech), and 0.01 with mRNA-1273 (Moderna).[1] [2] [3] Its main features are the presence of acute arterial or venous thrombosis, severe thrombocytopenia, elevated D-dimer, and demonstration of platelet factor 4 (PF4) antibodies in the first 42 days after vaccination.[4] [5] [6] TTS is usually associated to a severe thrombosis profile, affecting multiple organs, most frequently cerebral venous sinus, splanchnic veins, and deep veins with pulmonary embolism. We describe an illustrative case of isolated thrombosis of the carotid artery causing stroke with mildly altered laboratory parameters. The patient provided written informed consent for this report.

Publication History

Received: 09 August 2021

Accepted: 16 October 2021

Accepted Manuscript online:
20 October 2021

Article published online:
29 December 2021

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