Thrombectomy for delayed basilar stent occlusion with good outcome

Area of Science:

• Endovascular neurosurgery
• Cerebrovascular disease management
• Interventional neuroradiology

Background:

• Neurovascular stents are crucial for treating aneurysms but carry a risk of in-stent thrombosis, potentially leading to stroke.
• Prompt recognition and management of in-stent thrombosis are essential for interventionalists.

Purpose of the Study:

• To report a case of successful delayed treatment for in-stent thrombosis of the basilar artery.
• To highlight treatment options for post-stenting thrombotic events.

Main Methods:

• A 46-year-old male underwent stent-supported embolization for a basilar aneurysm.
• The patient developed complete basilar artery occlusion due to in-stent thrombosis 6 weeks post-procedure.
• Delayed thrombectomy and thrombolysis were performed after 24 hours of symptom onset.

Main Results:

• Despite a significant delay in presentation and complete basilar artery occlusion, the patient achieved a good clinical outcome following intervention.
• The case demonstrates the potential efficacy of late intervention for neurovascular stent thrombosis.

Conclusions:

• Delayed thrombectomy and thrombolysis can be effective in managing acute basilar artery occlusion secondary to in-stent thrombosis.
• This case underscores the importance of considering aggressive revascularization strategies even in delayed presentations of neurovascular stent thrombosis.