Korean J Anesthesiol.  2008 Aug;55(2):254-258. 10.4097/kjae.2008.55.2.254.

Acute cerebral infarction due to thrombus formation during GDC embolization for the treatment of intracranial aneurysm: A case report

• Han SJ
• Lee JH
• Jang IS
• Kim HT
• Kwon YE

• KMID: 2299215
• DOI: http://doi.org/10.4097/kjae.2008.55.2.254

Abstract

Although Guglielmi Detachable Coil (GDC) endovascular treatment of intracranial aneurysms has become an alternative to surgery, the main complication continues to be thromboembolic events. In our patient, we found thrombus at the third branch of the right middle cerebral artery after coil embolization. We added intravenous heparin and gave abciximab, an antiplatelet agent through the catheter. We then elevated the blood pressure and administered intravenous colloid solution to maintain adequate collateral circulation. One day later, the patient presented with acute focal infartion in the right frontal lobe and we treated her with low molecular weight heparin. After seven days, the patient's symptoms disappeared, and there was no residual neurological deficit. Therefore, we believe potential clinical complications can be avoided through early recognition of thrombus and appropriate medical therapy. Furthermore, it is necessary to prevent hypotension and to maintain proper hematocrit levels during operations in patients having risk factors for thrombosis.

Keyword

acute infarction; aneurysm; GDC; thrombus

MeSH Terms

Aneurysm
Antibodies, Monoclonal
Blood Pressure
Catheters
Cerebral Infarction
Collateral Circulation
Colloids
Frontal Lobe
Hematocrit
Heparin
Heparin, Low-Molecular-Weight
Humans
Hypotension
Immunoglobulin Fab Fragments
Intracranial Aneurysm
Middle Cerebral Artery
Risk Factors
Thrombosis
Antibodies, Monoclonal
Colloids
Heparin
Heparin, Low-Molecular-Weight
Immunoglobulin Fab Fragments