TY - JOUR
T1 - Use of aspirin as sole oral antiplatelet therapy in acute flow diversion for ruptured dissecting aneurysms
AU - Chiu, Albert Ho Yuen
AU - Ramesh, Rajalakshmi
AU - Wenderoth, Jason
AU - Davies, Mark
AU - Cheung, Andrew
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Subarachnoid hemorrhage secondary to rupture of a circumferential dissecting aneurysm continues to be a treatment dilemma. Vessel sacrifice, when possible, continues to be the safest option but in certain cases this is not possible due to lack of collateral supply. In such cases, coil assisted endovascular flow diversion has become a potential option but the requirement for dual antiplatelet therapy in an unsecured intracranial aneurysm continues to raise concern.We present a 48-year-old man with a World Federation of Neurological Surgeons grade 5 subarachnoid hemorrhage, secondary to a ruptured intradural left vertebral artery dissecting aneurysm, who was treated successfully with a pipeline embolization device with Shield technology using aspirin and a single intravenous loading dose of abciximab. To our knowledge, this is the first case of an acute flow diversion performed using only aspirin as the sole oral antiplatelet agent.
AB - Subarachnoid hemorrhage secondary to rupture of a circumferential dissecting aneurysm continues to be a treatment dilemma. Vessel sacrifice, when possible, continues to be the safest option but in certain cases this is not possible due to lack of collateral supply. In such cases, coil assisted endovascular flow diversion has become a potential option but the requirement for dual antiplatelet therapy in an unsecured intracranial aneurysm continues to raise concern.We present a 48-year-old man with a World Federation of Neurological Surgeons grade 5 subarachnoid hemorrhage, secondary to a ruptured intradural left vertebral artery dissecting aneurysm, who was treated successfully with a pipeline embolization device with Shield technology using aspirin and a single intravenous loading dose of abciximab. To our knowledge, this is the first case of an acute flow diversion performed using only aspirin as the sole oral antiplatelet agent.
KW - Administration, Intravenous
KW - Administration, Oral
KW - Aneurysm, Ruptured/diagnostic imaging
KW - Aspirin/administration & dosage
KW - Embolization, Therapeutic/instrumentation
KW - Humans
KW - Male
KW - Middle Aged
KW - Platelet Aggregation Inhibitors/administration & dosage
KW - Subarachnoid Hemorrhage/diagnostic imaging
KW - Vertebral Artery Dissection/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85021849326&partnerID=8YFLogxK
U2 - 10.1136/neurintsurg-2016-012657.rep
DO - 10.1136/neurintsurg-2016-012657.rep
M3 - Article
C2 - 27683754
VL - 9
SP - e18
JO - Journal of neurointerventional surgery
JF - Journal of neurointerventional surgery
SN - 1759-8478
IS - 5
ER -