Multiple Sites of Arterial Thrombosis in A 35-Year Old Patient after ChAdOx1 (AstraZeneca) Vaccination, Requiring Emergent Femoral and Carotid Surgical Thrombectomy

Ann Vasc Surg. 2022 Feb;79:438.e1-438.e4. doi: 10.1016/j.avsg.2021.07.033. Epub 2021 Oct 10.

Abstract

Background: Vaccine Induced Thrombotic Thrombocytopenia (VITT) is a rare complication following ChAdOx1 (AstraZeneca) vaccination. Venous thrombosis in unusual sites such as splachnic or intracranial thrombosis, is the commonest manifestation.

Case report: We report a 35-year-old male patient who presented with acute left leg ischemia and thrombocytopenia 11-days after vaccination requiring emergent thrombectomy. During work-up, a localized thrombus was detected in the left carotid bifurcation mandating carotid thrombectomy. Localized right iliac thrombus causing a non-limiting flow stenosis was treated conservatively. The platelet aggregating capacity of patient's plasma was confirmed in a functional assay, thereby establishing VITT.

Conclusion: To the best of our knowledge this is the first case presenting multiple arterial thromboses requiring surgical treatment after ChAdOx1 vaccination.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / etiology
  • Arterial Occlusive Diseases / surgery*
  • Carotid Artery Thrombosis / diagnostic imaging
  • Carotid Artery Thrombosis / etiology
  • Carotid Artery Thrombosis / surgery*
  • ChAdOx1 nCoV-19 / administration & dosage
  • ChAdOx1 nCoV-19 / adverse effects*
  • Femoral Artery / diagnostic imaging
  • Femoral Artery / surgery*
  • Humans
  • Iliac Artery / diagnostic imaging
  • Male
  • Thrombectomy*
  • Thrombosis / diagnostic imaging
  • Thrombosis / etiology
  • Thrombosis / surgery*
  • Treatment Outcome
  • Vaccination / adverse effects*

Substances

  • ChAdOx1 nCoV-19