Ischemic complications of basilar artery stenting
Patient No. | Time of Onset Relative to Stenting | Anti-Thrombotic Medications at Time of Ictus | Clinical Presentation | Acute Infarcts (Imaging Modality) | Catheter Angiography | Acute Treatment | Maintenance Therapy |
---|---|---|---|---|---|---|---|
5 | Immediate | Abciximab | Deep coma; after withdrawal of support, patient died on poststent day 10 | Right cerebellum and anterior pons (CT) | Not performed | Not applicable | Not applicable |
6 | Day 4 | Clopidogrel, aspirin* | Vertigo, ataxia | Left cerebellum (MRI) | No acute abnormality | Heparin, clopidogrel, aspirin × 8 days | Clopidogrel, aspirin |
Day 12 | Clopidogrel, aspirin | Hemiparesis | Left middle cerebellar peduncle (MRI) | No acute abnormality | Heparin, tirofiban × 4 days | Enoxaparin, warfarin, aspirin | |
Day 17 | Aspirin, enoxaparin, warfarin (INR = 2.03 seconds) | Dysarthria, hemiplegia | Left pons (MRI) | Not performed | Heparin, tirofiban × 7 days | Enoxaparin, warfarin, aspirin | |
7 | Day 2 | Tirofiban | Ophthalmoplegia, dysarthria, hemiplegia | Right pons (MRI) | Stent thrombosis | Endovascular mechanical thrombectomy and tirofiban × 2 days | Warfarin, tirofiban |
8 | Day 1 | Abciximab | Hemiplegia, respiratory failure | Right pons (MRI) | No acute abnormality | Heparin × 6 days. | Warfarin, clopidogrel, aspirin |
Note:—INR indicates international normalized ratio; MRI, MR imaging;
* , when aspirin is indicated, 325 mg/day.