Endovascular trapping for vertebral artery fusiform aneurysm in a patient with idiopathic thrombocytopenic purpura.
A 56-year-old woman with adult idiopathic thrombocytopenic purpura (ITP) diagnosed 17 years previously presented with a fusiform aneurysm manifesting as chronic headache. She had suffered no major hemorrhagic complications, although her platelet counts were between 3.0 x 10(9)/l and 50.0 x 10(9)/l. Magnetic resonance angiography identified a fusiform aneurysm of the right vertebral artery. Endovascular trapping after high-dose gammaglobulin with steroid therapy was performed. The patient received antiplatelet therapy to prevent thromboembolic events. The parent artery and aneurysm were completely occluded with no hemorrhagic complications. Endovascular treatment is considered safe in patients with ITP, although careful periprocedural management of platelet count is required.
Ishihara
Hideyuki
H
Department of Neurosurgery, Kobe City General Hospital, Kobe, Hyogo. hishi@yamaguchi-u.ac.jp
Sakai
Nobuyuki
N
Kuroiwa
Terumasa
T
Kunieda
Takeharu
T
Osaka
Naohiro
N
Morizane
Asuka
A
Sakai
Chiaki
C
Yano
Tatsuya
T
Kajikawa
Ryuichiro
R
Kikuchi
Haruhiko
H
D001921:Brain / Q000098:blood supply; D020520:Brain Infarction / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D002532:Intracranial Aneurysm / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D020300:Intracranial Hemorrhages / Q000517:prevention & control; D020767:Intracranial Thrombosis / Q000188:drug therapy / Q000517:prevention & control; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications*; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D020217:Vertebral Artery Dissection / Q000209:etiology* / Q000473:pathology / Q000628:therapy*
D016756:Immunoglobulins, Intravenous; D010975:Platelet Aggregation Inhibitors; D013256:Steroids