학술논문
Carotid free-floating thrombus in COVID-19: a cerebrovascular disorder of cytokine storm-related immunothrombosis.
Document Type
Article
Author
Pensato, Umberto; Forlivesi, Stefano; Gentile, Mauro; Romoli, Michele; Muccioli, Lorenzo; Ambrosi, Francesca; Foschini, Maria Pia; Gallo, Carmine; Ballestrazzi, Maria Sandra; Teutonico, Paolo; Faggioli, Gianluca; Gargiulo, Mauro; Galluzzo, Simone; Taglialatela, Francesco; Simonetti, Luigi; Zini, Andrea
Source
Subject
*CEREBROVASCULAR disease
*THROMBOSIS
*COVID-19
*NEUROLOGIC manifestations of general diseases
*STROKE
*THYROID crisis
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Language
ISSN
1590-1874
Abstract
Backgrounds: Several neurological manifestations, including stroke, have been reported in COVID-19 patients. The putative role of the COVID-19-related hyperinflammatory state in cerebrovascular disorders remains unclear. Methods: From March 2020 to September 2021, we searched for patients who exhibited an ischemic stroke related to carotid free-floating thrombus (CFFT) to investigate its incidence and relationship with COVID-19. Results: Of 853 ischemic strokes referred to our Stroke Centre during the study period, 5.7% (n = 49) were positive for SARS-CoV-2. Six had CFFT, of which two tested positive for SARS-CoV-2 (2/49 = 4.1%), and four did not (4/802 = 0.5%). The former were two middle-aged men suffering from COVID-19 pneumonia. Floating thrombi were promptly extracted by endarterectomy and endovascular thrombectomy, respectively, with no early and long-term complications. Notably, our COVID-19 patients exhibited little or no atherosclerosis burden on CT angiography, markedly elevated D-dimer levels, and extensive thrombus length. Conclusions: COVID-19-induced immunothrombosis possibly played a significant pathogenic role in CFFT. [ABSTRACT FROM AUTHOR]