title: Symptomatic Very Delayed Parent Artery Occlusion After Flow Diversion Stent Embolization.
abstract: Flow diversion stents (FDSs) are constructed from high-density braided mesh, which alters intra-aneurysmal hemodynamics and leads to aneurysm occlusion by inducing thrombus formation. Although there are potential complications associated with FDS embolization, one of the serious complications is the parent artery occlusion due to the in-stent thrombosis. A 72-year-old woman with a symptomatic giant fusiform aneurysm in the cavernous segment of ICA underwent single-layer pipeline embolization device (PED) embolization. Six-month and 1-year follow-up conventional angiographies showed the residual blood flow in the aneurysm. Two-year follow-up MRI showed the aneurysm sac shrinkage and the antiplatelet therapy was discontinued. The patient suffered from symptomatic parent artery occlusion due to the in-stent thrombosis, 4 months after antiplatelet therapy discontinuation. The patient with the incompletely occluded aneurysm after PED embolization should be given long-term antiplatelet therapy because of the risk of delayed parent artery occlusion.
authors.affiliation: Department of Neuroendovascular Therapy, Juntendo University School of Medicine.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Oishi
authors.forename: Kosuke
authors.initials: K
authors.lastname: Teranishi
authors.forename: Senshu
authors.initials: S
authors.lastname: Nonaka
authors.forename: Munetaka
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Hajime
authors.initials: H
authors.lastname: Arai
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000628:therapy*; D002340:Carotid Artery Diseases / Q000628:therapy*; D002343:Carotid Artery, Internal; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors