Rescue treatment with tPA for refractory thromboembolism during stent-assisted coiling of a ruptured intracranial aneurysm: A case report

被引：0

作者：

Kim, Sanghyeon ^{[1
]}

Kang, Myongjin ^{[1
]}

机构：

[1] Dong A Univ Hosp, Busan Ulsan Reg Cardiocerebrovasc Dis Ctr, Dept Radiol, 3-1Ga Dongdaeshin Dong, Busan 602715, South Korea

来源：

NEUROLOGY ASIA | 2023年 / 28卷 / 03期

关键词：

Thromboembolism; cerebral aneurysm; stent; coiling; tissue plasminogen activator; thrombectomy; ENDOVASCULAR TREATMENT; INTRAARTERIAL; COMPLICATIONS; EMBOLIZATION; ABCIXIMAB; TIROFIBAN; INFUSION; THERAPY; EVENTS;

D O I：

10.54029/2023pcj

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Thromboembolic complications during stent-assisted coiling of ruptured intracranial aneurysms are major complications that can cause serious neurological deficits. Management strategies include medical thrombolysis, mechanical thrombectomy with suction aspiration or stent retrieval, and rescue stenting. The existing literature suggests that tissue plasminogen activator agents should be used cautiously because of the high risk of severe bleeding at the aneurysm. We present the case of a ruptured anterior communicating artery aneurysm. Acute in-stent thrombosis occurred during the stent-assisted coiling of the aneurysm. Rescue therapy with tirofiban, suction aspiration, and rescue stenting was attempted; however, these methods failed. Finally, tissue plasminogen activator infusion was performed, which successfully dissolved the thrombus and restored blood flow. Follow-up brain computed tomography revealed no increase in hemorrhage volume.

引用

页码：725 / 729

页数：5

共 19 条

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