Thrombectomy for delayed basilar stent occlusion with good outcome.

ABSTRACT: Neurovascular stents have revolutionized the endovascular treatment of wide-necked and fusiform aneurysms; however, potential in-stent thrombosis-resulting in devastating strokes-complicates their use. Interventionalists using these devices must be aware of treatment options for such events. We present the case of a 46-year-old man who underwent stent-supported embolization of an incidental basilar aneurysm followed by in-stent thrombosis 6 weeks later. Though he presented at that time after 24 h of symptom onset with complete occlusion of the basilar artery, delayed thrombectomy and thrombolysis resulted in a good clinical outcome. LIST OF ABBREVIATIONS: IVintravenousACTactivated coagulation timeDWI MRIdiffusion weighted magnetic resonance imagingIAintra-arterialtPAtissue plasminogen activatorICHintracranial hemorrhage. LIST OF PROPRIETARY DEVICES CITED IN TEXT: Enterprise Vascular Reconstructive Device ®, Codman Neurovascular, Raynham, MA Excelsior SL 10 microcatheter, Target Therapeutics/Stryker, Fremont, CA Prowler Plus Select microcatheter, Codman Neurovascular MPD Envoy catheter, Codman Neurovascular Penumbra .032" Reperfusion catheter, Penumbra Inc., San Leandro, CA Transend .014" microwire, Target/Stryker Merci Concentric Retriever ®, Concentric Medical/Stryker, Mountainview, CA.