Surgical and Endovascular Management of Aortic Thrombosis in COVID-19 and Vaccine-Induced Immune Thrombotic Thrombocytopenia

COVID-19 has been associated with a hypercoagulable state, leading to various thrombotic complications, including aortic thrombosis, a rare but severe manifestation requiring surgical intervention. Additionally, vaccine-induced immune thrombotic thrombocytopenia (VITT), linked to adenoviral vector vaccines, presents unique surgical challenges due to a heightened risk of thrombosis and bleeding. This review focuses on the surgical management of COVID-19-associated aortic thrombosis and VITT-related large-vessel occlusions.

Surgical intervention in COVID-19-associated aortic thrombosis depends on thrombus burden, patient stability, and associated comorbidities. Open thrombectomy, aortic bypass, and hybrid endovascular techniques have been employed, with perioperative anticoagulation being critical to prevent recurrence. High thrombus burden cases often require open repair