Arterial floating mural thrombi are a characteristic imaging pattern in SARS-CoV-2-related ischemic stroke.

Autor: Pardo K; Department of Neurology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel., Harnof O; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel., Barnea R; Department of Neurology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel., Naftali J; Department of Neurology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel., Kenan G; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.; Department of Neurology, Shamir Medical Center, Be'er Ya'akov, Israel., Auriel E; Department of Neurology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel., Peretz S; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.; Department of Neurology, Shamir Medical Center, Be'er Ya'akov, Israel.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Oct 25; Vol. 19 (10), pp. e0311622. Date of Electronic Publication: 2024 Oct 25 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0311622
Abstrakt: Background: Acute ischemic stroke (AIS) is a complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We aimed to explore neurovascular imaging patterns in patients with SARS-CoV-2-related AIS.
Methods: We retrospectively analyzed clinical and radiological data of patients hospitalized with AIS and a positive PCR test for SARS-CoV-2 prior to AIS onset. The control group comprised of AIS patients from a pre-COVID-19 pandemic period matched for gender and age.
Results: Thirty-five SARS-CoV-2-related stroke patients, and 35 controls were included. Fifty-seven percent of SARS-CoV-2 patients had either mild or asymptomatic disease. A distinctive imaging pattern of floating arterial mural thrombus was detected in 5 patients of the SARS-CoV-2 group. In 4 patients thrombus was attached to a stenotic atherosclerotic plaque in the proximal internal carotid artery. In the 5th patient a cardiac CTA showed multiple floating thrombi in the descending aorta. In the control group, floating thrombus was only detected in one patient. Treatment with dual antiplatelet therapy was associated with thrombus dissolution and good clinical outcome. Patients with floating thrombi had a longer time from SARS-CoV-2 diagnosis to stroke onset (mean 7.4 versus 3.4 days).
Conclusions: Floating arterial mural thrombi attached to atherosclerotic plaques are unique characteristic source of AIS in SARS-CoV-2 patients. They may lead to ischemic stroke in patients with mild or asymptomatic infection up to 1-2 weeks from SARS-CoV-2 diagnosis. Patients with embolic AIS and SARS-CoV-2 diagnosis should perform high resolution cranio-cervical vascular imaging to evaluate floating thrombi as a potential embolic source.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Pardo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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