Aortic Valve Thrombus, Stroke, and Endovascular Thrombectomy in a Child
with APML and Trisomy 21
Abstract
Acute pro-myelocytic leukemia (APML) is associated with an elevated risk
of bleeding and thrombosis due to disseminated intravascular coagulation
that is frequently present prior to initiation of therapy. We report the
case of a 13 year-old male with Trisomy 21 diagnosed with APML found to
have an asymptomatic aortic valve thrombus who developed a
thromboembolic arterial ischemic stroke. Endovascular thrombectomy (EVT)
restored cerebral circulation and a fibrin thrombus containing APML
cells was retrieved. The patient made a neurologic recovery, nearing his
baseline within one week post-EVT. We highlight that thromboembolic
stroke can be a rare complication in APML and present unique management
challenges.