Mechanical thrombectomy for internal carotid artery occlusion in a patient with ulcerative colitis in remission on oral tofacitinib： a case report

Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disease known to be associated with extraintestinal complications, including thrombosis. While thrombosis is often observed during the active phase of UC, its occurrence during remission remains unclear. We report a case of a 38-year-old female patient with UC in remission who developed internal carotid artery occlusion while on tofacitinib. Mechanical thrombectomy was performed, resulting in a favorable outcome. The patient had no signs of active inflammation, and laboratory tests did not indicate a hypercoagulable state. Histopathological analysis of the retrieved thrombus revealed an arterial thrombus rich in platelets and fibrin. While UC-related thrombotic complications were initially considered, the potential impact of tofacitinib, a Janus kinase (JAK) inhibitor, on thrombotic risk was also suspected. This case highlights the need for careful thrombotic risk assessment in UC patients, even during remission, especially those receiving JAK inhibitors.