Cited 0 times in

44 1

Rescue therapy for acute thromboembolic occlusion during endovascular treatment of cerebral aneurysms

Other Titles
 뇌동맥류의 혈관내 치료 중 발생한 급성 혈색전성 폐색증의 구조 치료 
Issue Date
2012
Description
Dept. of Medicine/박사
Abstract
Background and Purpose:One of the most common complications that occurrs during the treatment of cerebral aneurysm is acute thromboembolic occlusion. With the advent of endovascular devices and techniques, various recanalization methods have been introduced. We report our experience with rescue therapies for acute thromboembolic occlusions during endovascular treatment of cerebral aneurysms.Materials and Methods: From March 2009 to February 2011, acute thromboembolic events occurred in 7 patients among 153 cases of endovascular coil embolization. We performed rescue treatment for these 7 patients using endovascular methods. Our protocol for recanalization includes intra-arterial chemical and/or mechanical thrombolysis. Urokinase, glycoprotein IIb-IIIa inhibitor (Tirofiban) and self-expandable stents were used for recanalization. We assessed the recanalization results with a TICI (Thrombolysis in cerebral infarction) grading system immediately after the rescue therapy, and clinical outcomes were reviewed. Results: Two men and 5 women (age range 49~69, mean age 56 years) were treated with rescue therapy. All 7 patients presented with subarachnoid hemorrhage; intra-arterial chemical thrombolysis was successful in 3, and their TICI grades were 2a (n=3). In the other 4 patients, successful recanalization was achieved with a self-expandable stent, and 3 of them had favorable outcomes as TICI grades were 2b (n=1) or 3 (n=2). Emergency bypass surgery was performed in one patient after a failed endovascular recanalization procedure. Conclusions:With these rescue treatments, we can minimize permanent neurological deficits from thromboembolic complications after endovascular procedures. Stent-assisted revascularization with concomitant administration of IIb-IIIa inhibitors contributed to the achievement of increased recanalization rates.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/133707
Appears in Collections:
2. 학위논문 > 1. College of Medicine (의과대학) > 박사
사서에게 알리기
  feedback
Fulltext
 
Export
RIS (EndNote)
XLS (Excel)
XML

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse