title: Treatment and outcome of intracranial hemorrhage after carotid artery stenting. A ten year single center experience.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Capital Medical University, Xuan Wu Hospital. Beijing, China - ling-feng@vip.163.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Xu
authors.forename: Y
authors.initials: Y
authors.lastname: Wanga
authors.forename: L
authors.initials: L
authors.lastname: Feng
authors.forename: Z
authors.initials: Z
authors.lastname: Miao
authors.forename: F
authors.initials: F
authors.lastname: Ling
references.citation: Catheter Cardiovasc Interv. 2001 Dec;54(4):521-3
references.pmid: 11747193
references.citation: Neurosurgery. 2004 May;54(5):1258-61; discussion 1261-2
references.pmid: 15113483
references.citation: AJNR Am J Neuroradiol. 2006 Aug;27(7):1508-13
references.pmid: 16908570
references.citation: Neurosurgery. 2003 Nov;53(5):1053-58; discussion 1058-60
references.pmid: 14580271
references.citation: N Engl J Med. 1991 Aug 15;325(7):445-53
references.pmid: 1852179
references.citation: J Am Coll Cardiol. 2004 May 5;43(9):1596-601
references.pmid: 15120817
references.citation: J Endovasc Ther. 2007 Feb;14(1):77-85
references.pmid: 17291153
references.citation: Stroke. 1999 Nov;30(11):2483-6
references.pmid: 10548688
references.citation: Catheter Cardiovasc Interv. 2000 Jun;50(2):160-7
references.pmid: 10842380
references.citation: J Endovasc Surg. 1999 Nov;6(4):337-41
references.pmid: 10893135
references.citation: Lancet Neurol. 2005 Dec;4(12):877-88
references.pmid: 16297845
references.citation: Neuroradiology. 2004 May;46(5):399-403
references.pmid: 15098142
references.citation: Cerebrovasc Dis. 2000 Sep-Oct;10(5):374-9
references.pmid: 10971023
references.citation: Angiology. 2002 Mar-Apr;53(2):217-23
references.pmid: 11952114
references.citation: J Invasive Cardiol. 2009 Jan;21(1):27-30
references.pmid: 19126924
references.citation: Clin Res Cardiol. 2006 Mar;95(3):186-91
references.pmid: 16598533
references.citation: Zhonghua Yi Xue Za Zhi. 2002 May 25;82(10):657-60
references.pmid: 12133460
references.citation: Neuroradiology. 2009 Mar;51(3):169-74
references.pmid: 19104793
references.citation: J Neurosurg. 2007 Dec;107(6):1130-6
references.pmid: 18077950
references.citation: J Neurosurg. 1988 Apr;68(4):532-6
references.pmid: 3351580
references.citation: J Neurosurg. 2002 May;96(5):830-6
references.pmid: 12005390
references.citation: Stroke. 2002 Jul;33(7):1916-9
references.pmid: 12105375
references.citation: Neurosurgery. 2000 Aug;47(2):335-43; discussion 343-5
references.pmid: 10942006
references.citation: AJNR Am J Neuroradiol. 2000 Nov-Dec;21(10):1911-6
references.pmid: 11110546
references.citation: J Neuroradiol. 2004 Jan;31(1):63-6
references.pmid: 15026733
references.citation: Stroke. 2000 Mar;31(3):792-3
references.pmid: 10700520