Table 2.
Case reports of endovascular therapy in SVT due to COVID-19 or VITT.
| Reference | Etiology | Laboratory Findings | Treatment | Outcome | Location | Complications | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Author (Year) | Study Type | n | COVID-19 (C-19), VITT | d (After Index) | Treatment Allocation | Endovascular Treatment | mRS | Recanalization | |||
| Ostovan et al. (2021) [62] | case series | 1 (of 9) | C-19 | 5 (?) | TP (140 T/uL), elevated D-dimer levels (>10.000 ng/mL) | ICH | LT plus MT (A) | 6 | full | SSS, TS | NN |
| Cavalcanti et al. (2020) [63] | case series | 1 (of 3) | C-19 | 10 | TP (141 T/uL), elevated D-dimer levels (>55.000 ng/mL) | edema, rapid deterioration | MT (A) plus LT (micro-catheter, cont.) | 6 | partial | SSS, TS, SS, DV | NN |
| Omari et al. (2022) [64] | case report | 1 | C-19 | 30 | NN | visual deterioration, intracranial hypertension | NN | NN | NN | TS, S Sig | blindness |
| Sajjad et al. (2021) [65] | case report | 1 | C-19 | 20 | TP (NN), PF4 antibodies (NN), elevated D-dimer levels (6.3 mg/L) | ICH plus edema, coma, deterioration | Fogarty catheter | 2 | full | SSS | NN |
| Chew et al. (2021) [66] | case series | 6 | VITT (ChAdOx1 nCoV-19) * | 10 (−14) | TP (11 T-91 T/uL), PF4 antibodies and D-dimer levels NN | ICH (n = 5), progressive thrombus material, deterioration (coma) | Aspiration (Penumbra) | 0–1: n = 3; 6: n = 2 | satisf. (n = 5) | NN | n = 1 (ICH-progression) |
| Wolf et al. (2021) [67] | case series | 3 | VITT (ChAdOx1 nCoV-19) | 4 (−17) | TP (60 T–92 T/uL), PF4 antibodies (positive), elevated D-dimer levels (2120–22,800 ng/mL) | SAH (1); ICH (2); coma due to bilateral thalamic edema (3) | MT (A [1, 3] plus B [2]) | 0 (1, 3); 1 (2) | full | SSS, TS (1), SSS, TS, S Sig (2) | 2 MT sessions needed (2) |
| Cleaver at al. (2021) [68] | case series | 3 | VITT (ChAdOx1 nCoV-19) | 8 (−27) | TP (85 T/uL [1], 23 T/uL [2], 35 T/uL [3]); PF4-antibodies positive (all), elevated D-dimer levels (15.83–30.34 μg/mL) | progr. ICH/SAH, edema and deterioration (1); progr. ICH and thrombus material (2); new ICH, status epilepticus, intubation (3) | MT (A [1], A plus SR [2]) | 2 (all) | full (2), partial (1, 3) | SSS (1), SS, S Sig, TS (2), SSS, S Sig, TS (3) | NN |
| Gurjar et al. (2022) [69] | case report | 1 | VITT (mRNA-1273 vaccine) ** | 3 months | TP (139 T/uL), PF4 antibodies (negative), elevated D-dimer levels (16.666 ng/mL) | coma, progressive symptoms | MT (not specified) | 3 | full | SSS, TS, S Sig | NN |
| Mirandola et al. (2022) [70] | case report | 1 | VITT (ChAdOx1 nCoV-19) | 15 | TP (40 T/uL), PF4 antibodies (positive), elevated D-dimer levels (18 mcg/mL) | progressive thrombus material, edema, coma and seizure requiring intubation | MT (A plus SR) | 0 | partial (SS), full (rest) | SSS, SS, TS, S Sig | NN |
| Choi et al. (2021) [71] | case report | 1 | VITT (ChAdOx1 nCoV-19) | 12 | TP (14 T/uL), PF4 antibodies (positive), elevated D-dimer levels (>32.5 mg/L [reference: < 0.5]) | progressive coma | MT (not specified) | 6 | full | S Sig | NN |
| Waraich et al. (2021) [72] | case report | 1 | VITT (ChAdOx1 nCoV-19) | 13 | TP (14 T/uL), PF4 antibodies NN, elevated D-dimer levels (62.342 ng/mL) | deterioration, SAH, seizures requiring CPR | NN | NN (2 ***) | full | SSS, TS, S Sig | NN |
* ChAdOx1 nCoV-19, AstraZeneca vaccine; ** mRNA-1273 vaccine, Moderna; *** not specified, mRS assumed by the authors depending on the symptom description provided; n, number; VITT, vaccine-induced thrombotic thrombocytopenia; d, days; mRS, modified Rankin Scale; TP, thrombocytopenia; PF4; platelet factor 4; T, thousand; ICH, intracerebral hemorrhage; SHA, subarachnoid hemorrhage; CPR, cardiopulmonary resuscitation; NN, unknown; SSS, sagittal superior sinus; SS, straight sinus; S Sig, sigmoid sinus; TS, transverse sinus; DV, deep cerebral veins; SVT, sinus or cerebral vein thrombosis; MT, mechanical thrombectomy; LT, local (intrasinus) thrombolysis; A, aspiration thrombectomy; SR, stent retriever thrombectomy; B, balloon guided thrombectomy or angioplasty; cont, continuous.