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Incidence of delayed ipsilateral intraparenchymal hemorrhage after stent-assisted coiling of intracranial aneurysms in a high-volume single center

  • Interventional Neuroradiology
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Abstract

Introduction

Delayed ipsilateral intraparenchymal hemorrhage (IPH) has been reported following technically successful treatment of intracranial aneurysms using flow-diverting stents in up to 8.5 % of patients. We report a similar, though less frequent phenomenon in the setting of stent-assisted coil embolization.

Methods

Institutional review board approval was obtained. A retrospective analysis of a prospective neurointerventional procedure registry was performed to review all IPHs that occurred in aneurysm patients within 90 days of endovascular treatment performed between November 2002 and November 2014 at one institution. Age, sex, hypertension, dual antiplatelet therapy, and technical details of the procedure were recorded.

Results

A total of 1697 patients underwent endovascular treatment of an intracranial aneurysm without a flow diverter at our institution during the study period. Among these, 138 patients underwent stent-assisted coiling (8.1 %). Of these, three patients (2.2 %) suffered a delayed IPH within the vascular territory distal to the treated lesion (one woman, median age 60 years).

Conclusions

Recently described in the setting of flow diversion, delayed ipsilateral IPH is not limited to flow-diverting stents. Though less frequent, a potential for this complication may exist following any intracranial stenting procedure, possibly related to hemorrhagic conversion of microembolic phenomena in the setting of dual antiplatelet or anticoagulation therapy.

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Authors and Affiliations

  1. Division of Interventional Neuroradiology, Neuroscience Institute, Abbott Northwestern Hospital, Consulting Radiologists Ltd, Mail Route 11113, 800 E. 28th Street, Minneapolis, MN, 55407, USA

    Yasha Kayan, Josser E. Delgado Almandoz, Jennifer L. Fease, Kira Tran, Anna M. Milner & Jill M. Scholz

Authors
  1. Yasha Kayan
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  2. Josser E. Delgado Almandoz
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  3. Jennifer L. Fease
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  4. Kira Tran
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  5. Anna M. Milner
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  6. Jill M. Scholz
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Corresponding author

Correspondence to Yasha Kayan.

Ethics declarations

We declare that all human and animal studies have been approved by the Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

YK consults for Medtronic and Microvention. JEDA consults for Accriva, Medtronic, Microvention, Penumbra and Sequent.

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Kayan, Y., Almandoz, J.E.D., Fease, J.L. et al. Incidence of delayed ipsilateral intraparenchymal hemorrhage after stent-assisted coiling of intracranial aneurysms in a high-volume single center. Neuroradiology 58, 261–266 (2016). https://doi.org/10.1007/s00234-015-1624-3

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  • DOI: https://doi.org/10.1007/s00234-015-1624-3

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