Treatment and outcome of intracranial hemorrhage after carotid artery stenting. A ten year single center experience.
Intracranial hemorrhage following carotid artery stenting (CAS) is a rare but potentially devastating complication. The present study reviewed intracranial hemorrhage cases from patients undergoing CAS in ten years to find the methods to rescue patients from this fatal complication. Patients with postoperative intracranial hemorrhage following CAS were retrospectively selected, and clinical features, treatments and outcomes were studied. Ten patients with intracranial hemorrhage were identified. The mean onset time of hemorrhage was 6.1-/+7.1h. Intracerebral hemorrhage occurred in eight patients and SAH in two patients. The patients were treated by stopping anti-platelet and anticoagulant for at least three days, and surgical drainage of the hematoma/ventricle drainage or conservative treatment. Six patients survived, two had left moderate paralysis, four had a good recovery at four week follow-up, and four patients died. No patients underwent thrombosis in stent after withdrawing of antiplatelet and anticoagulant. Intracranial hemorrhage after CAS occurs usually in a few hours and leads to catastrophic results. Once patients have intracranial hemorrhage, good neurocritical care may help to save them. Stopping antiplatelet and anticoagulant for at least three days may avoid thrombosis in the stenting site.
Xu
Y
Y
Department of Neurosurgery, Capital Medical University, Xuan Wu Hospital. Beijing, China - ling-feng@vip.163.com.
Wanga
Y
Y
Feng
L
L
Miao
Z
Z
Ling
F
F
Catheter Cardiovasc Interv. 2001 Dec;54(4):521-3
11747193
Neurosurgery. 2004 May;54(5):1258-61; discussion 1261-2
15113483
AJNR Am J Neuroradiol. 2006 Aug;27(7):1508-13
16908570
Neurosurgery. 2003 Nov;53(5):1053-58; discussion 1058-60
14580271
N Engl J Med. 1991 Aug 15;325(7):445-53
1852179
J Am Coll Cardiol. 2004 May 5;43(9):1596-601
15120817
J Endovasc Ther. 2007 Feb;14(1):77-85
17291153
Stroke. 1999 Nov;30(11):2483-6
10548688
Catheter Cardiovasc Interv. 2000 Jun;50(2):160-7
10842380
J Endovasc Surg. 1999 Nov;6(4):337-41
10893135
Lancet Neurol. 2005 Dec;4(12):877-88
16297845
Neuroradiology. 2004 May;46(5):399-403
15098142
Cerebrovasc Dis. 2000 Sep-Oct;10(5):374-9
10971023
Angiology. 2002 Mar-Apr;53(2):217-23
11952114
J Invasive Cardiol. 2009 Jan;21(1):27-30
19126924
Clin Res Cardiol. 2006 Mar;95(3):186-91
16598533
Zhonghua Yi Xue Za Zhi. 2002 May 25;82(10):657-60
12133460
Neuroradiology. 2009 Mar;51(3):169-74
19104793
J Neurosurg. 2007 Dec;107(6):1130-6
18077950
J Neurosurg. 1988 Apr;68(4):532-6
3351580
J Neurosurg. 2002 May;96(5):830-6
12005390
Stroke. 2002 Jul;33(7):1916-9
12105375
Neurosurgery. 2000 Aug;47(2):335-43; discussion 343-5
10942006
AJNR Am J Neuroradiol. 2000 Nov-Dec;21(10):1911-6
11110546
J Neuroradiol. 2004 Jan;31(1):63-6
15026733
Stroke. 2000 Mar;31(3):792-3
10700520