Rebleeding from a vertebral artery dissecting aneurysm after endovascular internal trapping

Adverse effect of intrathecal urokinase injection or incomplete occlusion? - Case report

Kenji Sugiu, Koji Tokunaga, Shigeki Ono, Ayumi Nishida, Isao Date

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

A 67-year-old woman suffered rebleeding from a ruptured vertebral artery dissecting aneurysm after endovascular internal trapping. The dissecting aneurysm was initially successfully occluded with the affected vertebral artery using detachable coils. However, rebleeding from the aneurysm occurred on the next day. The rebleeding may have resulted from the thrombolytic effect of urokinase, which was injected intrathecally 3 hours before rebleeding occurred, or the relatively loose coil packing of the aneurysm. This case indicates the potential risk of intrathecal use of thrombolytic agents and the importance of complete tight coil packing of the whole dissected site in the treatment of ruptured vertebral artery dissecting aneurysms.

Original languageEnglish
Pages (from-to)597-600
Number of pages4
JournalNeurologia Medico-Chirurgica
Volume49
Issue number12
DOIs
Publication statusPublished - 2009

Fingerprint

Vertebral Artery Dissection
Spinal Injections
Urokinase-Type Plasminogen Activator
Aneurysm
Dissecting Aneurysm
Fibrinolytic Agents
Vertebral Artery
Therapeutics

Keywords

  • Coil
  • Endovascular treatment
  • Internal trapping
  • Rebleeding
  • Thrombolytic agent

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

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abstract = "A 67-year-old woman suffered rebleeding from a ruptured vertebral artery dissecting aneurysm after endovascular internal trapping. The dissecting aneurysm was initially successfully occluded with the affected vertebral artery using detachable coils. However, rebleeding from the aneurysm occurred on the next day. The rebleeding may have resulted from the thrombolytic effect of urokinase, which was injected intrathecally 3 hours before rebleeding occurred, or the relatively loose coil packing of the aneurysm. This case indicates the potential risk of intrathecal use of thrombolytic agents and the importance of complete tight coil packing of the whole dissected site in the treatment of ruptured vertebral artery dissecting aneurysms.",
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AU - Date, Isao

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AB - A 67-year-old woman suffered rebleeding from a ruptured vertebral artery dissecting aneurysm after endovascular internal trapping. The dissecting aneurysm was initially successfully occluded with the affected vertebral artery using detachable coils. However, rebleeding from the aneurysm occurred on the next day. The rebleeding may have resulted from the thrombolytic effect of urokinase, which was injected intrathecally 3 hours before rebleeding occurred, or the relatively loose coil packing of the aneurysm. This case indicates the potential risk of intrathecal use of thrombolytic agents and the importance of complete tight coil packing of the whole dissected site in the treatment of ruptured vertebral artery dissecting aneurysms.

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