Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and Therapy

Detalhes bibliográficos
Autor(a) principal: Baptista, Tiago
Data de Publicação: 2012
Outros Autores: Braz, Ana, Patrício, Madalena, Fragata, Isabel, Reis, João
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/257
Resumo: Thromboembolic phenomena are the most commonly reported complications during endovascular treatment of intracranial aneurysms with coils. Frequency of this complication varies in the literature, but authors reported rates ranging from 2.5 to 28%. Several mechanisms may be involved in the formation and migration of thrombus: it may be already existing inside the aneurysm and be dislocated and then migrate distally; it can be formed on the surface of the coils or catheters used, or it can appear in the remnant aneurysm sac it. Studies have shown a higher incidence of thromboembolic complications in wide neck aneurysms. In this paper we discuss the importance of prevention of thromboembolic complications during and after endovascular treatment of ruptured intracranial aneurysms. We also refer options and strategies to adopt in the event of a vascular occlusion is detected during the procedure, as the administration of inhibitors of glycoprotein IIb/IIIa or the release of an intra-cranial stent. Illustrative cases are shown. The prevention of thromboembolic complications and rapid action after the vascular occlusion is essential in order to improve the prognosis of patients undergoing endovascular treatment of ruptured intracranial aneurysms. Extensive knowledge of available options is essential to the pursuit of that goal.
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spelling Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and TherapyComplicações Tromboembólicas Durante a Terapêutica Endovascular de Aneurismas Rotos Intra-cranianos - Profilaxia e TerapêuticaThromboembolic phenomena are the most commonly reported complications during endovascular treatment of intracranial aneurysms with coils. Frequency of this complication varies in the literature, but authors reported rates ranging from 2.5 to 28%. Several mechanisms may be involved in the formation and migration of thrombus: it may be already existing inside the aneurysm and be dislocated and then migrate distally; it can be formed on the surface of the coils or catheters used, or it can appear in the remnant aneurysm sac it. Studies have shown a higher incidence of thromboembolic complications in wide neck aneurysms. In this paper we discuss the importance of prevention of thromboembolic complications during and after endovascular treatment of ruptured intracranial aneurysms. We also refer options and strategies to adopt in the event of a vascular occlusion is detected during the procedure, as the administration of inhibitors of glycoprotein IIb/IIIa or the release of an intra-cranial stent. Illustrative cases are shown. The prevention of thromboembolic complications and rapid action after the vascular occlusion is essential in order to improve the prognosis of patients undergoing endovascular treatment of ruptured intracranial aneurysms. Extensive knowledge of available options is essential to the pursuit of that goal.As complicações tromboembólicas são as mais frequentemente reportadas durante a terapêutica endovascular de aneurismas intracranianos com espiras metálicas. A frequência deste tipo de complicação varia na literatura, contudo autores referem uma incidência entre 2,5 e 28%. Diversos mecanismos poderão estar envolvidos na formação e migração do trombo: pode ser já preexistente no interior do aneurisma a tratar e deslocar-se para o vaso portador; pode formar-se de novo na superfície das espiras ou dos cateteres utilizados; ou ainda no eventual colo residual se o grau de oclusão não for completo. Estudos demonstraram maior incidência de complicações tromboembólicas em aneurismas de colo largo. Neste trabalho discutimos a importância e justificação de medidas utilizadas na prevenção de complicações tromboembólicas durante e após a terapêutica endovascular de aneurismas rotos intra-cranianos. Referem-se ainda as opções e estratégias a adoptar na eventualidade de uma oclusão vascular ser detectada durante o procedimento, como a administração de inibidores da glicoproteina IIb/IIIa ou mesmo a libertação de stents intra-cranianos. Diversos casos exemplificativos são exibidos. A prevenção de complicações tromboembólicas e a rápida actuação perante a oclusão vascular são essenciais para a melhoria do prognóstico dos doentes submetidos a terapêutica endovascular de aneurismas rotos. O conhecimento profundo das opções disponíveis é essencial para a persecução desse objectivo.Ordem dos Médicos2012-11-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/257oai:ojs.www.actamedicaportuguesa.com:article/257Acta Médica Portuguesa; Vol. 25 (2012): Supplement 1; 25-29Acta Médica Portuguesa; Vol. 25 (2012): Suplemento 1; 25-291646-07580870-399Xreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/257https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/257/66Baptista, TiagoBraz, AnaPatrício, MadalenaFragata, IsabelReis, Joãoinfo:eu-repo/semantics/openAccess2022-12-20T10:55:54Zoai:ojs.www.actamedicaportuguesa.com:article/257Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T10:36:12.300304Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and Therapy
Complicações Tromboembólicas Durante a Terapêutica Endovascular de Aneurismas Rotos Intra-cranianos - Profilaxia e Terapêutica
title Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and Therapy
spellingShingle Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and Therapy
Baptista, Tiago
title_short Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and Therapy
title_full Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and Therapy
title_fullStr Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and Therapy
title_full_unstemmed Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and Therapy
title_sort Thromboembolic Complications During Endovascular Treatment of Ruptured Intracranial Aneurysms – Prevention and Therapy
author Baptista, Tiago
author_facet Baptista, Tiago
Braz, Ana
Patrício, Madalena
Fragata, Isabel
Reis, João
author_role author
author2 Braz, Ana
Patrício, Madalena
Fragata, Isabel
Reis, João
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Baptista, Tiago
Braz, Ana
Patrício, Madalena
Fragata, Isabel
Reis, João
description Thromboembolic phenomena are the most commonly reported complications during endovascular treatment of intracranial aneurysms with coils. Frequency of this complication varies in the literature, but authors reported rates ranging from 2.5 to 28%. Several mechanisms may be involved in the formation and migration of thrombus: it may be already existing inside the aneurysm and be dislocated and then migrate distally; it can be formed on the surface of the coils or catheters used, or it can appear in the remnant aneurysm sac it. Studies have shown a higher incidence of thromboembolic complications in wide neck aneurysms. In this paper we discuss the importance of prevention of thromboembolic complications during and after endovascular treatment of ruptured intracranial aneurysms. We also refer options and strategies to adopt in the event of a vascular occlusion is detected during the procedure, as the administration of inhibitors of glycoprotein IIb/IIIa or the release of an intra-cranial stent. Illustrative cases are shown. The prevention of thromboembolic complications and rapid action after the vascular occlusion is essential in order to improve the prognosis of patients undergoing endovascular treatment of ruptured intracranial aneurysms. Extensive knowledge of available options is essential to the pursuit of that goal.
publishDate 2012
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publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 25 (2012): Supplement 1; 25-29
Acta Médica Portuguesa; Vol. 25 (2012): Suplemento 1; 25-29
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