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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
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Unstable Carotid Artery Thrombus in a Patient With COVID-19 Infection
Patrick J Kato1, Jesse Kato1, Jarred A Napier1
1Department of Surgery, Section of Vascular and Endovascular Surgery, Trinity Health Ann Arbor, Ypsilanti, MI, USA.
Vascular and Endovascular Surgery
|March 18, 2024
Summary
This case study highlights a COVID-19-related stroke in an unvaccinated patient, successfully treated with carotid artery thrombectomy and anticoagulation for spontaneous arterial thrombosis.
Area of Science:
- Neurology
- Cardiology
- Infectious Diseases
Background:
- COVID-19 infection is increasingly associated with hypercoagulable states.
- Cerebrovascular events, including stroke, are potential complications of SARS-CoV-2 infection.
- Understanding the specific mechanisms of COVID-19-related stroke is crucial for effective management.
Observation:
- An unvaccinated 43-year-old female presented with a left hemispheric stroke during acute COVID-19 infection.
- Computed tomography angiography revealed a non-occlusive carotid thrombus with a target lesion, suggesting an embolic source.
- The clinical and radiographic findings pointed towards a hypercoagulable-related embolism as the stroke etiology.
Findings:
- The patient underwent successful left carotid artery thrombectomy and bovine pericardial patch angioplasty for stenosis.
- Operative findings confirmed a left carotid thrombus with minimal associated plaque.
- The procedure addressed the acute embolic event and potential underlying carotid artery disease.
Implications:
- This case demonstrates the efficacy of extracranial carotid thrombectomy and therapeutic anticoagulation for managing COVID-19-associated spontaneous arterial thrombosis.
- It provides a treatment paradigm for similar complex cerebrovascular events in the context of active viral infection.
- Further research into the prothrombotic mechanisms of COVID-19 is warranted to refine stroke prevention and treatment strategies.
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