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Published on: October 20, 2017
Basilar artery dissection treated by Neuroform stenting: fungal stent infection
Ratul Raychaudhuri1, Wengui Yu, Kimoo Hatanpaa
1Department of Neurological Surgery, Univesity of Texas Southwestern Medical Center, Dallas, TX 75390-8855, USA.
Background:
The authors describe a case of basilar artery dissection treated with Neuroform stenting. This new treatment modality for basilar artery dissection may be safer than anticoagulation in patients with subarachnoid hemorrhage. However, complications associated with stenting should be taken into careful consideration. These complications include thromboembolism and stent infection.
Case Description:
This 36-year-old white male underwent Neuroform stenting of basilar artery dissection and subsequently developed bilateral pontine infarct and fungal stent infection. This is worrisome in an otherwise healthy 36-year-old. Thromboembolism is a well-known phenomenon with endovascular stenting that may be improved with evolution in stent technology. Fungal infection of Neuroform stent in a patient with no history of immunocompromised status is of major concern. The patient subsequently underwent successful treatment of stent infection through parenteral antifungal agent.
Conclusions:
This case report highlights the potential pitfalls of Neuroform stenting of basilar artery dissection and potential methods by which to avert these complications. Further evolution in stent technology may help prevent further complications involving Neuroform stenting of basilar artery dissection. In addition, the successful treatment of stent infection through parenteral agent demonstrates the increasing efficacy of novel antifungal agent in the treatment of these infections.
Insights
Neuroform stenting for basilar artery dissection can cause complications like thromboembolism and fungal infection. Successful treatment of fungal stent infection with antifungal agents is demonstrated.
Area of Science:
- Neurology
- Interventional Neuroradiology
Background:
- Basilar artery dissection is a serious condition.
- Neuroform stenting is a potential treatment for basilar artery dissection, possibly safer than anticoagulation for patients with subarachnoid hemorrhage.
- Potential complications of stenting include thromboembolism and infection.
Observation:
- A 36-year-old male with basilar artery dissection underwent Neuroform stenting.
- The patient developed bilateral pontine infarct and a fungal stent infection.
- The patient had no history of immunocompromised status.
Findings:
- Thromboembolism is a known complication of endovascular stenting.
- Fungal stent infection is a significant concern, even in non-immunocompromised patients.
- Successful treatment of fungal stent infection was achieved with parenteral antifungal agents.
Implications:
- This case highlights potential pitfalls of Neuroform stenting for basilar artery dissection.
- Further advancements in stent technology may reduce complications.
- Novel antifungal agents show efficacy in treating stent infections.
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