Fatal hemorrhage after attempted treatment of a basilar artery stenosis. Case report.
Interventional treatment of severe intracranial stenoses using angioplasty and stent placement carries a significant risk of severe adverse events. These events are frequently caused by the intraarterial dilation but may also be precipitated by other causes related to the procedure. The authors describe a fatal subarachnoid hemorrhage during the treatment of a basilar artery (BA) stenosis caused by a vascular rupture distant from the site of angioplasty. After successful balloon dilation, an attempt to deploy a self-expanding stent failed due to the severe kinking of the stenotic segment of the BA. The angiogram performed during the intervention revealed a fatal rupture of the BA in a location not related to the angioplasty or guide wire tip. The technical aspects of the intervention are analyzed on the basis of the postmortem findings.
Gralla
Jan
J
Department of Neuroradiology, West Wing, John Radcliffe Hospital, Oxford, UK. jan.gralla@insel.ch
Rennie
Adam T M
AT
Squire
Wayne
W
Rothwell
Peter M
PM
Kuker
Wilhem
W
D017130:Angioplasty / Q000009:adverse effects*; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology; D017809:Fatal Outcome; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012421:Rupture; D015607:Stents; D014715:Vertebrobasilar Insufficiency / Q000473:pathology* / Q000628:therapy*