Case report: Late in-stent thrombosis in a patient with vertebrobasilar dolichoectasia after stent-assisted coil embolization due to the discontinuation of antiplatelet therapy

Zhe Ji; Wanxin Yang; Yongjie Ma; Lisong Bian; Guilin Li; Yongjuan Fu; Yueshan Piao; Hongqi Zhang

doi:10.3389/fneur.2023.1129816

Case report: Late in-stent thrombosis in a patient with vertebrobasilar dolichoectasia after stent-assisted coil embolization due to the discontinuation of antiplatelet therapy

Front Neurol. 2023 Apr 12:14:1129816. doi: 10.3389/fneur.2023.1129816. eCollection 2023.

Authors

Zhe Ji¹, Wanxin Yang¹, Yongjie Ma¹, Lisong Bian², Guilin Li¹, Yongjuan Fu³, Yueshan Piao³, Hongqi Zhang¹

Affiliations

¹ Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
² Department of Neurosurgery, Beijing Haidian Hospital, Peking University, Haidian, China.
³ Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Abstract

Vertebrobasilar dolichoectasia (VBD) is a rare type of cerebrovascular disorder with high rates of morbidity and mortality. Due to the distinct pathological characteristics that fragmented internal elastic lamina and multiple dissections, VBD is difficult to treat and cured. Stent-assisted coil embolization is one of the main treatment modalities for such lesions. However, the duration of healing remained questionable, and there were no effective measures for evaluating endothelial coverage. Before complete endothelial coverage, the discontinuation of antiplatelet therapy may lead to fatal in-stent thrombosis; however, continued antiplatelet therapy could also result in bleeding complications. Thus, we present an autopsy case of late in-stent thrombosis due to the discontinuation of antiplatelet therapy and systematically review the literature to provide a reference for endovascular treatment and antiplatelet regimen of VBD.

Keywords: aneurysm—dissecting; autopsy; case report; stent assisted coil embolization; thrombosis.

Publication types

Case Reports

Grants and funding

This study was funded by the National Key Research Development Program grant number 2016YFC1300800 and Beijing Scientific and Technologic Project grant number Z201100005520021.