Yonsei Med J.  2020 May;61(5):441-444. 10.3349/ymj.2020.61.5.441.

Does Systemic Lupus Erythematosus Increase the Riskof Procedure-Related Complication in EndovascularTreatment of Intracranial Aneurysm?

• Lee JH
• Lee SW
• Choi CH
• Ko JK

• KMID: 2500083
• DOI: http://doi.org/10.3349/ymj.2020.61.5.441

Abstract

Cerebral aneurysms associated with systemic lupus erythematosus (SLE) are more likely to grow rapidly and rupture, compared to those found in the general population. The main underlying pathology of intracranial aneurysm and its rupture is presumed to be SLE-related intracranial vasculitis and fragility of blood vessels due to prolonged use of steroid. For these reasons, both surgical and endovascular options are challenging. On the other hand, given the possibility that SLE may predispose to growth and rupture of intracranial aneurysm, early intervention for cerebral aneurysms associated with SLE may be more necessary and beneficial than other cerebral aneurysms in the general population. Here we would like to report on the unexpected complications that occurred during or after endovascular treatment of an SLE patient with multiple aneurysms. The complications include intraprocedural rupture of unruptured aneurysm, coil stretching, contrast-induced encephalopathy, and delayed ipsilateral intraparenchymal hemorrhage after stent-assisted coiling. Our unique case highlights that the SLE patient with multiple intracranial aneurysms had a higher risk of endovascular procedure-related complications, which might be due to the increased bleeding tendency and fragility of blood vessels.

Keyword

Cerebral aneurysm; endovascular treatment; systemic lupus erythematosus