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High flow extracranial-to-intracranial bypass for treatment of thrombotic parent vessel occlusion after stent-assisted aneurysm coiling as a potential rescue therapy.
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High flow extracranial-to-intracranial bypass for treatment of thrombotic parent vessel occlusion after stent-assisted aneurysm coiling as a potential rescue therapy.

World Neurosurg. 2019 Mar 13;:

Authors: Yi L, Zhao W, Krings T, Wang W, Chen J

Abstract
INTRODUCTION: Stent thrombosis (ST) is a known complication after intracranial stent implantation. The pathophysiology of ST is multifactorial and standardized treatments for ST remain uncertain.
CASE REPORT: A patient harboring an unruptured aneurysm of the posterior communicating segment of the left internal carotid artery (ICA) was treated with stent-assisted coil embolization while on dual anti-aggregation therapy. Despite adherence to medication, ST occurred eight days after the intervention. Following tirofiban infusion the thrombous dissolved and clinical symptoms improved. However, after tirofiban was stopped, the patient experienced again ischemic symptoms. The patient underwent high flow extracranial-to-intracranial (HF EC-IC) bypass with good patency of the graft and resolution of symptoms.
CONCLUSION: In case of refractory ST, HF EC-IC bypass proved to be in this case a feasible and effective rescue option.

PMID: 30878756 [PubMed - as supplied by publisher]

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