Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Very Late Stent Thrombosis after Sole Stent-Assisted Coiling at the Paraclinoid Giant Aneurysm : Could Prophylactic Antiplatelet Therapy Be Ceased at the Only 1 Year after Procedure?

  • Shin, Jung-Hoon (Department of Neurosurgery, Keimyung University School of Medicine) ;
  • Park, Seong-Ho (Department of Neurosurgery, Keimyung University School of Medicine) ;
  • Kim, Chang-Hyun (Department of Neurosurgery, Keimyung University School of Medicine) ;
  • Lee, Chang-Young (Department of Neurosurgery, Keimyung University School of Medicine)
  • Received : 2013.11.09
  • Accepted : 2014.09.29
  • Published : 2014.10.28
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Abstract

Stent thrombosis is a major limitation of stent-assisted coiling, which is an effective method for treating wide-necked aneurysms. Although early in-stent thrombosis has been reported, very late stent thrombosis (VLST) (>1 year) has not been reported following implantation of a single self-expandable stent designed for coiling. Herein, the authors present a case of VLST that occurred 14 months after single stent implantation in a large paraclinoid aneurysm with an ultra-wide neck involving the parent artery circumferentially. This case indicates the need for establishing guidelines regarding the optimal duration of prophylactic antiplatelet therapy following stent-assisted coiling, which remains undefined in the neuroendovascular field.

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References

  1. Amenta PS, Dalyai RT, Kung D, Toporowski A, Chandela S, Hasan D, et al. : Stent-assisted coiling of wide-necked aneurysms in the setting of acute subarachnoid hemorrhage : experience in 65 patients. Neurosurgery 70 : 1415-1429; discussion 1429, 2012 https://doi.org/10.1227/NEU.0b013e318246a4b1
  2. Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, et al. : Clinical end points in coronary stent trials : a case for standardized definitions. Circulation 115 : 2344-2351, 2007 https://doi.org/10.1161/CIRCULATIONAHA.106.685313
  3. Ebrahimi N, Claus B, Lee CY, Biondi A, Benndorf G : Stent conformity in curved vascular models with simulated aneurysm necks using flat-panel CT : an in vitro study. AJNR Am J Neuroradiol 28 : 823-829, 2007
  4. Farb A, Burke AP, Kolodgie FD, Virmani R : Pathological mechanisms of fatal late coronary stent thrombosis in humans. Circulation 108 : 1701-1706, 2003 https://doi.org/10.1161/01.CIR.0000091115.05480.B0
  5. Farb A, Sangiorgi G, Carter AJ, Walley VM, Edwards WD, Schwartz RS, et al. : Pathology of acute and chronic coronary stenting in humans. Circulation 99 : 44-52, 1999 https://doi.org/10.1161/01.CIR.99.1.44
  6. Fargen KM, Hoh BL, Welch BG, Pride GL, Lanzino G, Boulos AS, et al. : Long-term results of enterprise stent-assisted coiling of cerebral aneurysms. Neurosurgery 71 : 239-244; discussion 244, 2012 https://doi.org/10.1227/NEU.0b013e3182571953
  7. Fiorella D, Hsu D, Woo HH, Tarr RW, Nelson PK : Very late thrombosis of a pipeline embolization device construct : case report. Neurosurgery 67 (3 Suppl Operative) : onsE313-onsE314; discussion onsE314, 2010
  8. Grewe PH, Deneke T, Machraoui A, Barmeyer J, Muller KM : Acute and chronic tissue response to coronary stent implantation : pathologic findings in human specimen. J Am Coll Cardiol 35 : 157-163, 2000 https://doi.org/10.1016/S0735-1097(99)00486-6
  9. Grines CL, Bonow RO, Casey DE Jr, Gardner TJ, Lockhart PB, Moliterno DJ, et al. : Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents : a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol 49 : 734-739, 2007 https://doi.org/10.1016/j.jacc.2007.01.003
  10. Kanaan H, Jankowitz B, Aleu A, Kostov D, Lin R, Lee K, et al. : In-stent thrombosis and stenosis after neck-remodeling device-assisted coil embolization of intracranial aneurysms. Neurosurgery 67 : 1523-1532; discussion 1532-1533, 2010 https://doi.org/10.1227/NEU.0b013e3181f8d194
  11. Kim DJ, Suh SH, Lee JW, Kim BM, Lee JW, Huh SK, et al. : Influences of stents on the outcome of coil embolized intracranial aneurysms : comparison between a stent-remodeled and non-remodeled treatment. Acta Neurochir (Wien) 152 : 423-429, 2010 https://doi.org/10.1007/s00701-009-0522-z
  12. King SB 3rd, Smith SC Jr, Hirshfeld JW Jr, Jacobs AK, Morrison DA, Williams DO, et al. : 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention : a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. J Am Coll Cardiol 51 : 172-209, 2008 https://doi.org/10.1016/j.jacc.2007.10.002
  13. Krischek O, Miloslavski E, Fischer S, Shrivastava S, Henkes H : A comparison of functional and physical properties of self-expanding intracranial stents [Neuroform3, Wingspan, Solitaire, Leo+, Enterprise]. Minim Invasive Neurosurg 54 : 21-28, 2011 https://doi.org/10.1055/s-0031-1271681
  14. Lee CY, Ryu CW, Koh JS, Kim EJ : Total occlusion of the internal carotid artery by subacute in-stent thrombosis and subsequent spontaneous recanalization after stent-assisted coil embolization. Neurointervention 6 : 38-41, 2011 https://doi.org/10.5469/neuroint.2011.6.1.38
  15. Lin RJ, Tang SC, Jeng JS : Stroke due to late in-stent thrombosis following carotid stenting. Acta Neurol Taiwan 20 : 161-162, 2011
  16. Lopes D, Sani S : Histological postmortem study of an internal carotid artery aneurysm treated with the Neuroform stent. Neurosurgery 56 : E416; discussion E416, 2005 https://doi.org/10.1227/01.NEU.0000147977.07736.66
  17. Luo CB, Teng MM, Chang FC, Lin CJ, Guo WY, Chang CY : Stent-assisted coil embolization of intracranial aneurysms : a single center experience. J Chin Med Assoc 75 : 322-328, 2012 https://doi.org/10.1016/j.jcma.2012.05.003
  18. Mocco J, Fargen KM, Albuquerque FC, Bendok BR, Boulos AS, Carpenter JS, et al. : Delayed thrombosis or stenosis following enterprise-assisted stent-coiling : is it safe? Midterm results of the interstate collaboration of enterprise stent coiling. Neurosurgery 69 : 908-913; discussion 913-914, 2011 https://doi.org/10.1227/NEU.0b013e318228490c
  19. Szikora I, Berentei Z, Kulcsar Z, Barath K, Berez A, Bose A, et al. : Endovascular treatment of intracranial aneurysms with parent vessel reconstruction using balloon and self expandable stents. Acta Neurochir (Wien) 148 : 711-723; discussion 723, 2006 https://doi.org/10.1007/s00701-006-0785-6
  20. Thorell WE, Chow MM, Woo HH, Masaryk TJ, Rasmussen PA : Y-configured dual intracranial stent-assisted coil embolization for the treatment of wide-necked basilar tip aneurysms. Neurosurgery 56 : 1035-1040; discussion 1035-1040, 2005
  21. Valgimigli M, Campo G, Monti M, Vranckx P, Percoco G, Tumscitz C, et al. : Short- versus long-term duration of dual-antiplatelet therapy after coronary stenting : a randomized multicenter trial. Circulation 125 : 2015-2026, 2012 https://doi.org/10.1161/CIRCULATIONAHA.111.071589
  22. Wright RS, Anderson JL, Adams CD, Bridges CR, Casey DE Jr, Ettinger SM, et al. : 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction : a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in collaboration with the American Academy of Family Physicians, Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons. J Am Coll Cardiol 57 : e215-e367, 2011