Endovascular Thrombectomy for Large-Vessel Occlusion Strokes with Preexisting Intracranial Aneurysms

Cardiovasc Intervent Radiol. 2018 Sep;41(9):1399-1403. doi: 10.1007/s00270-018-1945-9. Epub 2018 May 22.

Abstract

Objective: This study aimed to investigate the safety of endovascular thrombectomy in acute ischemic stroke with preexisting intracranial aneurysms.

Methods: Patients with acute ischemic stroke due to large-artery occlusion combined with intracranial aneurysms, who received endovascular treatment, were analyzed retrospectively, and the procedure-related data were recorded.

Results: Among the 124 patients who suffered acute large-artery occlusion and received endovascular recanalization therapy, intracranial aneurysms were found in seven patients (5.6%). All the seven patients achieved successful recanalization, except one patient who suffered subarachnoid hemorrhage due to the rupture of aneurysm during the procedure.

Conclusions: The prevalence of preexisting cerebral aneurysms in patients with acute ischemic stroke is high, leading to a procedure-related rupture risk. Endovascular treatment devices must be used carefully in these patients, especially when the aneurysms are located within the area where the procedure is performed.

Keywords: Acute ischemic stroke; Endovascular treatment; Intracranial aneurysm; Large-artery occlusion; Rupture.

MeSH terms

  • Acute Disease
  • Aged
  • Arterial Occlusive Diseases / complications*
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / surgery*
  • Endovascular Procedures / methods
  • Female
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stroke / diagnostic imaging
  • Stroke / etiology*
  • Stroke / surgery
  • Thrombectomy / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome