Endovascular treatment in pregnancy
1Department of Neurosurgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan. ishii@kuhp.kyoto-u.ac.jp
Neurologia Medico-Chirurgica
|August 28, 2013
Summary
Endovascular treatments for stroke during pregnancy are feasible and safe for mothers and fetuses. Careful consideration of risks and benefits is crucial, especially for preventive treatments.
Area of Science:
- Neurology
- Vascular Surgery
- Obstetrics
Background:
- Pregnancy and the postpartum period carry an elevated risk of stroke.
- Timely treatment decisions are critical upon patient transfer to healthcare institutions.
Purpose of the Study:
- To review the feasibility and safety of endovascular treatment for stroke in pregnant patients.
- To discuss the considerations for both acute and preventive endovascular interventions during pregnancy.
Main Methods:
- Review of existing literature on endovascular stroke treatment in pregnancy.
- Analysis of safety data regarding pharmaceutical agents, devices, and radiation exposure.
- Evaluation of the risks and benefits of preventive endovascular procedures for asymptomatic vascular lesions.
Main Results:
- Endovascular treatments for acute stroke are feasible in pregnant patients, with most agents and devices being usable.
- Radiation exposure to the fetus can be minimized through optimal shielding, and conventional procedures show safe levels.
- Preventive endovascular treatment for asymptomatic lesions like aneurysms or AVMs remains controversial due to unknown risk-benefit balance.
Conclusions:
- Endovascular therapy for acute stroke is safe in pregnancy with appropriate precautions for medication and radiation.
- Preventive endovascular treatment decisions for asymptomatic conditions must be individualized after thorough patient consultation.
- Maternal and fetal safety are paramount, requiring comprehensive discussion of treatment pros and cons.
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