Oral verapamil in the prevention of recurrent cerebral ischaemia due to post-stent vasospasm

V Rastogi; G Asaithambi; A Patel; K Park; S Bidari; V S Hedna

doi:10.1111/jcpt.12387

Oral verapamil in the prevention of recurrent cerebral ischaemia due to post-stent vasospasm

J Clin Pharm Ther. 2016 Jun;41(3):365-367. doi: 10.1111/jcpt.12387. Epub 2016 Apr 6.

Authors

V Rastogi¹, G Asaithambi², A Patel¹, K Park¹, S Bidari³, V S Hedna⁴

Affiliations

¹ Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA.
² John Nasseff Neuroscience Institute and United Hospital, Allina Health, St. Paul, MN, USA.
³ Department of Radiology, University of Florida College of Medicine, Gainesville, FL, USA.
⁴ Department of Neurology, University of New Mexico, Albuquerque, NM, USA.

PMID: 27060706
DOI: 10.1111/jcpt.12387

Abstract

What is known and objective: Endovascular embolization of basilar tip aneurysms (BTA) is performed to prevent rupture, but little is known regarding post-procedural vasospasm and its consequences. We relate management of post-procedural vasospasm found in cardiovascular literature on this rare post-procedural intracranial complication.

Case description: A 52-year-old man develops ischaemic strokes after undergoing posterior cerebral artery (PCA) stent-assisted coil embolization of BTA. Work-up suggested that vasospasm was the cause of his strokes.

What is new and conclusion: Vasospasm after intracranial stenting may share similar pathophysiological features to coronary stenting, resulting in ischaemia. Verapamil should be considered an empiric therapy in prevention of stent-related vasospasm.

Keywords: calcium channel blocker; ischaemia; stent; stroke; vasospasm; verapamil.

Publication types

Case Reports