Intraarterial thrombolysis for thromboemboli associated with endovascular aneurysm coiling - Report of five cases

被引:19
作者
Koebbe, CJ
Horowitz, MB
Levy, EI
Dutton, K
Jungries, CC
Purdy, PD
机构
[1] Univ Pittsburgh, Med Ctr, Dept Neurol Surg, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Med Ctr, Dept Radiol, Pittsburgh, PA 15213 USA
[3] Univ Texas, SW Med Ctr, Dept Radiol, Dallas, TX USA
[4] Univ Texas, SW Med Ctr, Dept Neurosurg, Dallas, TX USA
来源
INTERVENTIONAL NEURORADIOLOGY | 2002年 / 8卷 / 02期
关键词
intraarterial thrombolysis; coiling complications; thromboemboli;
D O I
10.1177/159101990200800207
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
With the rapidly developing applications of GDC endovascular aneurysm embolization, the recognition and treatment of potential intra-procedural complications is crucial to reducing the morbidity and mortality of this procedure. Thromboembolic complications occur with an incidence of 2-11 % with endovascular aneurysm coiling. We describe five cases in which the intraarterial use of thrombolytics was applied to disrupt a fresh clot and recanalize the occluded vessels with variable angiographic and clinical success. Five cases are presented in which thromboembolic complications occurred during or shortly after GDC endovascular aneurysm occlusion. The complication was recognized while depositing coils in two cases, on post-embolization angiogram in one, and a few hours following embolization in two cases in which a new neurologic deficit developed in the ICU. In those cases recognized while the microcatheter was near the aneurysm site, immediate thrombolysis was performed at the site of occlusion. The patients who developed a new neurologic deficit were returned to the endovascular suite and the site of occlusion was noted to be distal to the coiled aneurysm. Clot disruption was performed with the microcatheter before delivering intraarterial thrombolytics. Thromboembolic complications of GDC aneurysm embolization are fortunately rare and can be managed with delivery of thrombolytic therapy at the site of occlusion. Intraarterial thrombolysis of fresh clot caused by GDC aneurysm occlusion can successfully open the occluded vessels but not without serious risk of hemorrhage.
引用
收藏
页码:151 / 158
页数:8
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