Hyperacute thrombosis of a vertebral artery stent with a single missed dose of a P2Y12 inhibitor and poor stent wall apposition: illustrative case
It is recommended to prioritize optimal wall stent apposition with oversized stents in patients without collateral circulation. The risk of thromboembolism due to poorly apposed stents is very high, even in delayed (> 6 months) settings. Stent construct revision or bypass grafting may not be feasible or desirable options. For patients without wall apposition, endothelialization may not occur, necessitating lifelong P2Y12 inhibitor therapy to prevent recurrent thromboembolic events. https://thejns.org/doi/10.3171/CASE24296.
Authors
- Hamza A. Shaikh (ORCID: https://orcid.org/0000-0001-8163-4600)
- Daniel A. Tonetti (ORCID: https://orcid.org/0000-0002-9258-1820)
- Jane Khalife (ORCID: https://orcid.org/0000-0003-3662-3886)
- Renato de Oliveira (ORCID: https://orcid.org/0000-0002-8656-5170)
- Manisha Koneru (ORCID: https://orcid.org/0000-0001-5012-6793)
- Joshua Santucci (ORCID: https://orcid.org/0000-0002-6324-4171)
- Pratit D. Patel (ORCID: https://orcid.org/0000-0002-8027-724X)
Institutions
- Cooper Medical School of Rowan University (US)
- Cooper University Health Care (US)
Publication Details
- Journal
- Journal of Neurosurgery Case Lessons
- Published
- 2024-10-28
- DOI
- https://doi.org/10.3171/case24296
- Citations
- 1
- Primary Topic
- Antiplatelet Therapy and Cardiovascular Diseases
- Type
- article
- Field-Weighted Citation Impact
- 0.40