Published in:
01-09-2021 | Computed Tomography | Imaging in Intensive Care Medicine
Thromboaspiration and fibrinolysis infusion for portomesenteric thrombosis after AstraZeneca COVID-19 vaccine administration
Published in: Intensive Care Medicine | Issue 9/2021
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A 57-year-old woman developed portomesenteric vaccine-associated immune thrombosis and thrombocytopenia (VITT) 12 days after a second administration of AstraZeneca (AZ) (ChAdOx1 nCov-19, UK) COVID-19 vaccine. Abdominal computed tomography (CT) demonstrated the absence of contrast filling of the portal trunk and portal branches and bilateral kidney corticomedullary triangular hypodensity corresponding to a complete thrombosis of the portal trunk and branches with bilateral segmental kidney infarcts (Fig. 1A).
Fig. 1
A 57-year-old woman developed portomesenteric vaccine-associate immune thrombosis and thrombocytopenia after a second administration of AstraZeneca COVID-19 vaccine. A Abdominal CT shows complete thrombosis of the portal trunk and the right portal branch (arrow), and left kidney infarcts (white stars). B Digital subtraction portography shows occlusion of the portal vein and branches, and the occlusion of the superior mesenteric vein (arrow). Obstruction of the portomesenteric veins result in the development of gastric and splenic collaterals (arrowheads). C Digital subtraction portography after mechanical thromboaspiration and 12 h fibrinolysis shows complete desobstruction of the portal trunk, the left portal branch and mesenteric vein (arrows) and marginated residual thrombus in the right portal branch (arrowhead). This desobstruction results in the disappearance of the venous collaterals. D Coronal reformatted abdominal CT in maximum intensity projection shows complete recanalization of the portomesenteric veins 7 days after treatment
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