Acute Intracranial In-Stent Thrombosis After Angioplasty of Middle Cerebral Artery Symptomatic Stenosis
| Autor: | Maciej Swiat, Małgorzata Pięta, Katarzyna Gruszczyńska, Miłosz Zbroszczyk, Grzegorz Opala, Maciej Jaworski, Jan Baron, Magdalena Targosz-Gajniak, M. Arkuszewski |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Middle Cerebral Artery medicine.medical_specialty Percutaneous medicine.medical_treatment Fibrinolytic Agents medicine.artery Internal medicine Angioplasty medicine Humans Thrombolytic Therapy cardiovascular diseases Stroke business.industry Infarction Middle Cerebral Artery General Medicine Thrombolysis Intracranial Arteriosclerosis medicine.disease Thrombosis Cerebral Angiography Surgery Ostium Stenosis Injections Intra-Arterial Tissue Plasminogen Activator Middle cerebral artery Cardiology Stents Neurology (clinical) business Angioplasty Balloon |
| Zdroj: | The Neurologist. 18:290-295 |
| ISSN: | 1074-7931 |
| Popis: | INTRODUCTION Intracranial atherosclerotic disease is one of the major risk factors of ischemic stroke. Percutaneous transluminal angioplasty with stent deployment may be effective for the treatment of symptomatic intracranial stenosis, however its value is yet to be determined. High possibility of serious periprocedural complications, such as acute in-stent thrombosis or stroke, narrows the current recommendations for this treatment to patients with high-grade stenosis (>70%), and to experienced neurointerventional centers. CASE REPORT We present a 44-year-old male with symptomatic high-grade stenosis of the M1 segment of left middle cerebral artery, treated with percutaneous transluminal angioplasty with stenting. The procedure was complicated with acute in-stent thrombosis treated with intra-arterial thrombolysis, which resulted in a nondisabling stroke. CONCLUSIONS The procedure-related stroke in this patient was probably caused by middle cerebral artery perforator ostium occlusion with balloon predilatation and transient in-stent thrombosis related to insufficient antiplatelet pretreatment. Exhausted cerebrovascular reserve due to long-lasting high-grade intracranial stenosis should also be considered as a factor contributing to ischemic complications. |
| Databáze: | OpenAIRE |
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