Multiple sites of arterial thrombosis in a 35-year old patient after ChAdOx1 (AstraZeneca) vaccination, requiring emergent femoral and carotid surgical thrombectomy

Lioudaki, Stella; Kontopodis, Nikolaos; Pontikoglou, Charalampos; Gkalea, Vasiliki; Pappas, Thomas; Matsouka, Charis; Papadaki, Eleni; Ioannou, Christos V

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