Skip to main content

Advertisement

SpringerLink
Log in

Thalamic hemorrhage following carotid angioplasty and stenting

  • Interventional Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Carotid angioplasty and stenting (CAS) has emerged as an alternative treatment of carotid stenosis for patients poorly suited for endarterectomy. Intracerebral hemorrhage following carotid revascularization is rare and thought to be related to hyperperfusion injury in most cases. Early experience suggests an increased incidence of hemorrhage following CAS as compared to endarterectomy. We describe a patient who suffered a thalamic hemorrhage following CAS. Because this hemorrhage occurred in a vascular territory unlikely to have been supplied by the treated artery, this case suggests that the mechanism of intracerebral hemorrhage following CAS may in some cases be different from the hyperperfusion hemorrhage classically described following endarterectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1 a
Fig. 2 a
Fig. 3 a

Similar content being viewed by others

References

  1. Ferguson GG, Eliasziw M, Barr HW, et al (1999) The North American Symptomatic Carotid Endarterectomy Trial: Surgical results in 1415 patients. Stroke 30:1751–1758

    CAS  PubMed  Google Scholar 

  2. Henderson RD, Phan TG, Piepgras DG, Wijdicks EF (2001) Mechanisms of intracerebral hemorrhage after carotid endarterectomy. J Neurosurg 95:964–969

    CAS  PubMed  Google Scholar 

  3. Piepgras DG, Morgan MK, Sundt TM Jr, Yanagihara T, Mussman LM (1988) Intracerebral hemorrhage after carotid endarterectomy. J Neurosurg 68:532–536

    CAS  PubMed  Google Scholar 

  4. Solomon RA, Loftus CM, Quest DO, Correll JW (1986) Incidence and etiology of intracerebral hemorrhage following carotid endarterectomy. J Neurosurg 64:29–34

    CAS  PubMed  Google Scholar 

  5. Morrish W, Grahovac S, Douen A, Cheung G, Hu W, Farb R, Kalapos P, Wee R, Hudon M, Agbi C, Richard M (2000) Intracranial hemorrhage after stenting and angioplasty of extracranial carotid stenosis. AJNR Am J Neuroradiol 21:1911–1916

    CAS  PubMed  Google Scholar 

  6. New G, Roubin GS, Iyer SS, Vitek JJ, Wholey MH, Diethrich EB, Hopkins LN, Hobson RW 2nd, Leon MB, Myla SV, et al (2000) Safety, efficacy, and durability of carotid artery stenting for restenosis following carotid endarterectomy: a multicenter study. J Endovasc Ther 7:345–352

    CAS  PubMed  Google Scholar 

  7. Roubin GS, New G, Iyer SS, Vitek JJ, Al-Mubarak N, Liu MW, Yadav J, Gomez C, Kuntz RE (2001) Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis: a 5-year prospective analysis. Circulation 103:532–537

    Google Scholar 

  8. Mathur A, Roubin GS, Iyer SS, et al (1998) Predictors of stroke complicating carotid artery stenting. Circulation 97:1239–1245

    CAS  PubMed  Google Scholar 

  9. Qureshi AI, Luft AR, Janardhan V, et al (2000). Identification of patients at risk for periprocedural neurological deficits associated with carotid angioplasty and stenting. Stroke 31:376–382

    CAS  PubMed  Google Scholar 

  10. McCabe DJH, Brown MM, Clifton A (1999) Fatal cerebral reperfusion hemorrhage after carotid stenting. Stroke 30:2483–2486

    CAS  PubMed  Google Scholar 

  11. Meyers PM, Higashida RT, Phatouros CC, Malek AM, Lempert TE, Dowd CF, Halbach VV (2000) Cerebral hyperperfusion syndrome after percutaneous transluminal stenting of the craniocervical arteries. Neurosurgery 47:335–343; discussion 343–335

    CAS  PubMed  Google Scholar 

  12. Mori T, Fukuoka M, Kazita K, Mima T, Mori K (1999). Intraventricular hemorrhage after carotid stenting. J Endovasc Surg 6:337–341

    CAS  PubMed  Google Scholar 

  13. Phatouros CC, Meyers PM, Higashida RT, Malek AM, Lempert TE, Dowd CF, Halbach VV (2002). Intracranial hemorrhage and cerebral hyperperfusion syndrome after extracranial carotid artery angioplasty and stent placement. AJNR Am J Neuroradiol 23:503–504

    PubMed  Google Scholar 

  14. Qureshi AI, Saad M, Zaidat OO, Suarez JI, Alexander MJ, Fareed M, Suri K, Ali Z, Hopkins LN (2002) Intracerebral hemorrhages associated with neurointerventional procedures using a combination of antithrombotic agents including abciximab. Stroke 33:1916–1919

    Article  CAS  PubMed  Google Scholar 

  15. Abbie A (1933) The clinical significance of the anterior choroidal artery. Brain 56:16–24

    Google Scholar 

  16. Cooper I (1954) Surgical alleviation of Parkinsonism: effect of occlusion of the anterior choroidal artery. J Am Geriatr Soc 11:691–718

    Google Scholar 

  17. Friedman JA, Pichelmann MA, Piepgras DG, Atkinson JLD, Maher CO, Meyer FB, Hansen KK (2001) Ischemic complications of surgery for anterior choroidal artery aneurysms. J Neurosurg 94:565–572

    CAS  PubMed  Google Scholar 

  18. Goldberg H (1974) The anterior choroidal artery. In: Newton T, Potts DG (eds) Radiology of the skull and brain.Mosby, St Louis, pp 1628–1658

  19. Rhoton AJ, Fujii K, Fradd B (1979) Microsurgical anatomy of the anterior choroidal artery. Surg Neurol 12:171–187

    PubMed  Google Scholar 

  20. Ejaz AA, Meschia JF (1999) Thalamic hemorrhage following carotid endarterectomy-induced labile blood pressure: controlling the lability with clonidine. Angiology 50:327–330

    CAS  PubMed  Google Scholar 

  21. Ouriel K, Shortell CK, Illig KA, Greenberg RK, Green RM (1999) Intracerebral hemorrhage after carotid endarterectomy: incidence, contribution to neurologic morbidity, and predictive factors. J Vasc Surg 29:82–87; discussion 87–89

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Neurosurgery, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA

    Jonathan A. Friedman

  2. Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA

    David F. Kallmes

  3. Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA

    Eelco F. M. Wijdicks

Authors
  1. Jonathan A. Friedman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David F. Kallmes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eelco F. M. Wijdicks
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan A. Friedman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Friedman, J.A., Kallmes, D.F. & Wijdicks, E.F.M. Thalamic hemorrhage following carotid angioplasty and stenting. Neuroradiology 46, 399–403 (2004). https://doi.org/10.1007/s00234-004-1199-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-004-1199-x

Keywords

Search

Navigation