Intracranial stenting as monotherapy in subarachnoid hemorrhage and sickle cell disease

J Neurointerv Surg. 2013 Mar;5(2):e4. doi: 10.1136/neurintsurg-2011-010224. Epub 2012 Jan 16.

Abstract

Introduction: Although there have been a few reports of coiling intracranial aneurysms in patients with sickle cell disease (SCD), there are no reports of intracranial stent placement in this patient population. A patient in whom stent placement was utilized as monotherapy to treat a blister-like aneurysm is described and the implications of SCD and endovascular treatment are discussed.

Case report: A 37-year-old man with SCD presented with diffuse subarachnoid hemorrhage. Angiography confirmed a 2 mm irregular aneurysm on the posterior cerebral artery which was treated with an oversized Neuroform 3 stent that was placed across the aneurysm neck by the senior author (KRB). Follow-up CT angiography showed no residual aneurysmal filling. The patient was discharged home in a stable condition, and he continues to do well 4 weeks following the procedure with no recurrence of the aneurysm.

Discussion: This report reviews hypercoagulability in SCD and the treatment options for intracranial aneurysms in patients with SCD. Additionally, the reported case suggests that intracranial stent placement may be a viable option for treating complex intracranial aneurysms in SCD patients.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Sickle Cell / complications
  • Anemia, Sickle Cell / diagnostic imaging*
  • Anemia, Sickle Cell / surgery
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery
  • Male
  • Radiography
  • Stents*
  • Subarachnoid Hemorrhage / complications
  • Subarachnoid Hemorrhage / diagnostic imaging*
  • Subarachnoid Hemorrhage / surgery
  • Treatment Outcome