Symptomatic Very Delayed Parent Artery Occlusion After Flow Diversion Stent Embolization
Flow diversion stents (FDSs) are constructed from high-density braided mesh, which alters intra-aneurysmal hemodynamics and leads to aneurysm occlusion by inducing thrombus formation. Although there are potential complications associated with FDS embolization, one of the serious complications is the...
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| Published in | Neurologia medico-chirurgica Vol. 56; no. 6; pp. 350 - 353 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Japan
The Japan Neurosurgical Society
01.01.2016
THE JAPAN NEUROSURGICAL SOCIETY |
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| Online Access | Get full text |
| ISSN | 0470-8105 1349-8029 1349-8029 |
| DOI | 10.2176/nmc.cr.2016-0053 |
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| Abstract | Flow diversion stents (FDSs) are constructed from high-density braided mesh, which alters intra-aneurysmal hemodynamics and leads to aneurysm occlusion by inducing thrombus formation. Although there are potential complications associated with FDS embolization, one of the serious complications is the parent artery occlusion due to the in-stent thrombosis. A 72-year-old woman with a symptomatic giant fusiform aneurysm in the cavernous segment of ICA underwent single-layer pipeline embolization device (PED) embolization. Six-month and 1-year follow-up conventional angiographies showed the residual blood flow in the aneurysm. Two-year follow-up MRI showed the aneurysm sac shrinkage and the antiplatelet therapy was discontinued. The patient suffered from symptomatic parent artery occlusion due to the in-stent thrombosis, 4 months after antiplatelet therapy discontinuation. The patient with the incompletely occluded aneurysm after PED embolization should be given long-term antiplatelet therapy because of the risk of delayed parent artery occlusion. |
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| AbstractList | Flow diversion stents (FDSs) are constructed from high-density braided mesh, which alters intra-aneurysmal hemodynamics and leads to aneurysm occlusion by inducing thrombus formation. Although there are potential complications associated with FDS embolization, one of the serious complications is the parent artery occlusion due to the in-stent thrombosis. A 72-year-old woman with a symptomatic giant fusiform aneurysm in the cavernous segment of ICA underwent single-layer pipeline embolization device (PED) embolization. Six-month and 1-year follow-up conventional angiographies showed the residual blood flow in the aneurysm. Two-year follow-up MRI showed the aneurysm sac shrinkage and the antiplatelet therapy was discontinued. The patient suffered from symptomatic parent artery occlusion due to the in-stent thrombosis, 4 months after antiplatelet therapy discontinuation. The patient with the incompletely occluded aneurysm after PED embolization should be given long-term antiplatelet therapy because of the risk of delayed parent artery occlusion. [Abstract] Flow diversion stents (FDSs) are constructed from high-density braided mesh, which alters intra-aneurysmal hemodynamics and leads to aneurysm occlusion by inducing thrombus formation. Although there are potential complications associated with FDS embolization, one of the serious complications is the parent artery occlusion due to the in-stent thrombosis. A 72-year-old woman with a symptomatic giant fusiform aneurysm in the cavernous segment of ICA underwent single-layer pipeline embolization device (PED) embolization. Six-month and 1-year follow-up conventional angiographies showed the residual blood flow in the aneurysm. Two-year follow-up MRI showed the aneurysm sac shrinkage and the antiplatelet therapy was discontinued. The patient suffered from symptomatic parent artery occlusion due to the in-stent thrombosis, 4 months after antiplatelet therapy discontinuation. The patient with the incompletely occluded aneurysm after PED embolization should be given long-term antiplatelet therapy because of the risk of delayed parent artery occlusion. |
| Author | TERANISHI, Kosuke NONAKA, Senshu YAMAMOTO, Munetaka ARAI, Hajime OISHI, Hidenori |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27169622$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1007/s00234-011-0948-x 10.3174/ajnr.A4329 10.1148/radiol.13130796 10.1161/STROKEAHA.111.000434 10.1016/j.wneu.2011.02.015 10.15274/INR-2014-10047 10.1016/j.jocn.2013.03.014 10.3174/ajnr.A2571 10.1148/radiol.13120099 10.3174/ajnr.A2421 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conflicts of Interest Disclosure All authors have registered online self-reported conflict of interest disclosure statement forms through the website for the Japan neurological society. No benefits in any form have been or will be received from any commercial party directly to the subject of this study. Informed consent of the patient for the use of this information was obtained. Institutional review board approval is not required for this type of retrospective study at our institution. |
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| References | 1) Murthy SB, Shah S, Venkatasubba Rao CP, Bershad EM, Suarez JI: Treatment of unruptured intracranial aneurysms with the pipeline embolization device. J Clin Neurosci 21: 6–11, 2014 7) Becske T, Kallmes DF, Saatci I, McDougall CG, Szikora I, Lanzino G, Moran CJ, Woo HH, Lopes DK, Berez AL, Cher DJ, Siddiqui AH, Levy EI, Albuquerque FC, Fiorella DJ, Berentei Z, Marosfoi M, Cekirge SH, Nelson PK: Pipeline for uncoilable or failed aneurysms: results from a multi-center clinical trial. Radiology 267: 858–868, 2013 10) Kadirvel R, Ding YH, Dai D, Rezek I, Lewis DA, Kallmes DF: Cellular mechanisms of aneurysm occlusion after treatment with a flow diverter. Radiology 270: 394–399, 2014 8) Nelson PK, Lylyk P, Szikora I, Wetzel SG, Wanke I, Fiorella D: The pipeline embolization device for the intracranial treatment of aneurysms trial. Am J Neuroradiol 32: 34–40, 2011 3) Fischer S, Vajda Z, Aguilar Perez M, Schmid E, Hopf N, Bazner H, Henkes H: Pipeline embolization device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections. Neuroradiology 54: 369–382, 2012 2) Lubicz B, Collignon L, Raphaeli G, De Witte O: Pipeline flow-diverter stent for endovascular treatment of intracranial aneurysms: preliminary experience in 20 patients with 27 aneurysms. World Neurosurg 76: 114–119, 2011 4) van Rooij WJ, Bechan RS, Peluso JP, Sluzewski M: Endovascular treatment of intracranial aneurysms in the flow diverter era: frequency of use and results in a consecutive series of 550 treatments in a single centre. Interv Neuroradiol 20: 428–435, 2014 5) Chiu AH, Cheung AK, Wenderoth JD, De Villiers L, Rice H, Phatouros CC, Singh TP, Phillips TJ, McAuliffe W: Long-term follow-up results following elective treatment of unruptured intracranial aneurysms with the pipeline embolization device. Am J Neuroradiol 36: 1728–1734, 2015 6) Klisch J, Turk A, Turner R, Woo HH, Fiorella D: Very late thrombosis of flow-diverting constructs after the treatment of large fusiform posterior circulation aneurysms. Am J Neuroradiol 32: 627–632, 2011 9) De Vries J, Boogaarts J, Van Norden A, Wakhloo AK: New generation of flow diverter (surpass) for unruptured intracranial aneurysms: a prospective single-center study in 37 patients. Stroke 44: 1567–1577, 2013 1 2 3 4 5 6 7 8 9 10 21436336 - AJNR Am J Neuroradiol. 2011 Apr;32(4):627-32 24086073 - Radiology. 2014 Feb;270(2):394-9 24055205 - J Clin Neurosci. 2014 Jan;21(1):6-11 21881914 - Neuroradiology. 2012 Apr;54(4):369-82 21148256 - AJNR Am J Neuroradiol. 2011 Jan;32(1):34-40 21839962 - World Neurosurg. 2011 Jul-Aug;76(1-2):114-9 23686973 - Stroke. 2013 Jun;44(6):1567-77 25999412 - AJNR Am J Neuroradiol. 2015 Sep;36(9):1728-34 25207905 - Interv Neuroradiol. 2014 Jul-Aug;20(4):428-35 23418004 - Radiology. 2013 Jun;267(3):858-68 |
| References_xml | – reference: 6) Klisch J, Turk A, Turner R, Woo HH, Fiorella D: Very late thrombosis of flow-diverting constructs after the treatment of large fusiform posterior circulation aneurysms. Am J Neuroradiol 32: 627–632, 2011 – reference: 3) Fischer S, Vajda Z, Aguilar Perez M, Schmid E, Hopf N, Bazner H, Henkes H: Pipeline embolization device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections. Neuroradiology 54: 369–382, 2012 – reference: 9) De Vries J, Boogaarts J, Van Norden A, Wakhloo AK: New generation of flow diverter (surpass) for unruptured intracranial aneurysms: a prospective single-center study in 37 patients. Stroke 44: 1567–1577, 2013 – reference: 4) van Rooij WJ, Bechan RS, Peluso JP, Sluzewski M: Endovascular treatment of intracranial aneurysms in the flow diverter era: frequency of use and results in a consecutive series of 550 treatments in a single centre. Interv Neuroradiol 20: 428–435, 2014 – reference: 7) Becske T, Kallmes DF, Saatci I, McDougall CG, Szikora I, Lanzino G, Moran CJ, Woo HH, Lopes DK, Berez AL, Cher DJ, Siddiqui AH, Levy EI, Albuquerque FC, Fiorella DJ, Berentei Z, Marosfoi M, Cekirge SH, Nelson PK: Pipeline for uncoilable or failed aneurysms: results from a multi-center clinical trial. Radiology 267: 858–868, 2013 – reference: 5) Chiu AH, Cheung AK, Wenderoth JD, De Villiers L, Rice H, Phatouros CC, Singh TP, Phillips TJ, McAuliffe W: Long-term follow-up results following elective treatment of unruptured intracranial aneurysms with the pipeline embolization device. Am J Neuroradiol 36: 1728–1734, 2015 – reference: 8) Nelson PK, Lylyk P, Szikora I, Wetzel SG, Wanke I, Fiorella D: The pipeline embolization device for the intracranial treatment of aneurysms trial. Am J Neuroradiol 32: 34–40, 2011 – reference: 2) Lubicz B, Collignon L, Raphaeli G, De Witte O: Pipeline flow-diverter stent for endovascular treatment of intracranial aneurysms: preliminary experience in 20 patients with 27 aneurysms. World Neurosurg 76: 114–119, 2011 – reference: 1) Murthy SB, Shah S, Venkatasubba Rao CP, Bershad EM, Suarez JI: Treatment of unruptured intracranial aneurysms with the pipeline embolization device. J Clin Neurosci 21: 6–11, 2014 – reference: 10) Kadirvel R, Ding YH, Dai D, Rezek I, Lewis DA, Kallmes DF: Cellular mechanisms of aneurysm occlusion after treatment with a flow diverter. Radiology 270: 394–399, 2014 – ident: 3 doi: 10.1007/s00234-011-0948-x – ident: 5 doi: 10.3174/ajnr.A4329 – ident: 10 doi: 10.1148/radiol.13130796 – ident: 9 doi: 10.1161/STROKEAHA.111.000434 – ident: 2 doi: 10.1016/j.wneu.2011.02.015 – ident: 4 doi: 10.15274/INR-2014-10047 – ident: 1 doi: 10.1016/j.jocn.2013.03.014 – ident: 6 doi: 10.3174/ajnr.A2571 – ident: 7 doi: 10.1148/radiol.13120099 – ident: 8 doi: 10.3174/ajnr.A2421 – reference: 21148256 - AJNR Am J Neuroradiol. 2011 Jan;32(1):34-40 – reference: 24055205 - J Clin Neurosci. 2014 Jan;21(1):6-11 – reference: 24086073 - Radiology. 2014 Feb;270(2):394-9 – reference: 25207905 - Interv Neuroradiol. 2014 Jul-Aug;20(4):428-35 – reference: 23418004 - Radiology. 2013 Jun;267(3):858-68 – reference: 25999412 - AJNR Am J Neuroradiol. 2015 Sep;36(9):1728-34 – reference: 21436336 - AJNR Am J Neuroradiol. 2011 Apr;32(4):627-32 – reference: 21881914 - Neuroradiology. 2012 Apr;54(4):369-82 – reference: 21839962 - World Neurosurg. 2011 Jul-Aug;76(1-2):114-9 – reference: 23686973 - Stroke. 2013 Jun;44(6):1567-77 |
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| Snippet | Flow diversion stents (FDSs) are constructed from high-density braided mesh, which alters intra-aneurysmal hemodynamics and leads to aneurysm occlusion by... [Abstract] Flow diversion stents (FDSs) are constructed from high-density braided mesh, which alters intra-aneurysmal hemodynamics and leads to aneurysm... |
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| SubjectTerms | Aged Aneurysm - therapy antiplatelet therapy Carotid Artery Diseases - therapy Carotid Artery, Internal Case Report delayed parent artery occlusion Embolization, Therapeutic - adverse effects Embolization, Therapeutic - instrumentation Female flow diversion stent Graft Occlusion, Vascular - diagnosis Graft Occlusion, Vascular - etiology Graft Occlusion, Vascular - therapy Humans intracranial aneurysm Stents - adverse effects Time Factors |
| Title | Symptomatic Very Delayed Parent Artery Occlusion After Flow Diversion Stent Embolization |
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