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Title: Management of Vertebral Stenosis Complicated by Presence of Acute Thrombus

Abstract

A 44-year-old male presented with multiple punctate acute infarcts of the vertebrobasilar circulation and a computed tomographic angiogram showing stenosis of the right vertebral origin. A digital subtraction angiogram demonstrated a new intraluminal filling defect at the origin of the stenotic vertebral artery where antegrade flow was maintained. This filling defect was accepted to be an acute thrombus of the vertebral origin, most likely due to rupture of a vulnerable plaque. The patient was treated with intravenous heparin. A control angiogram revealed dissolution of the acute thrombus under anticoagulation and the patient was treated with stenting with distal protection. Diffusion-weighted magnetic resonance imaging demonstrated no additional acute ischemic lesions. We were unable to find a similar report in the English literature documenting successful management of an acute vertebral ostial thrombus with anticoagulation. Anticoagulation might be considered prior to endovascular treatment of symptomatic vertebral stenoses complicated by the presence of acute thrombus.

Authors:
 [1];  [2];  [1];  [3];  [1];  [3]
  1. Hacettepe University School of Medicine, Department of Radiology (Turkey)
  2. Baylor College of Medicine, Department of Radiology (United States), E-mail: anilarat@netscape.net
  3. Hacettepe University School of Medicine, Department of Neurology (Turkey)
Publication Date:
OSTI Identifier:
21091021
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 30; Journal Issue: 2; Other Information: DOI: 10.1007/s00270-006-0016-9; Copyright (c) 2007 Springer Science+Business Media, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; DEFECTS; HEPARIN; NMR IMAGING; PATIENTS; RUPTURES

Citation Formats

Canyigit, Murat, Arat, Anil, Cil, Barbaros E., Sahin, Gurdal, Turkbey, Baris, and Elibol, Bulent. Management of Vertebral Stenosis Complicated by Presence of Acute Thrombus. United States: N. p., 2007. Web. doi:10.1007/S00270-006-0016-9.
Canyigit, Murat, Arat, Anil, Cil, Barbaros E., Sahin, Gurdal, Turkbey, Baris, & Elibol, Bulent. Management of Vertebral Stenosis Complicated by Presence of Acute Thrombus. United States. doi:10.1007/S00270-006-0016-9.
Canyigit, Murat, Arat, Anil, Cil, Barbaros E., Sahin, Gurdal, Turkbey, Baris, and Elibol, Bulent. Sun . "Management of Vertebral Stenosis Complicated by Presence of Acute Thrombus". United States. doi:10.1007/S00270-006-0016-9.
@article{osti_21091021,
title = {Management of Vertebral Stenosis Complicated by Presence of Acute Thrombus},
author = {Canyigit, Murat and Arat, Anil and Cil, Barbaros E. and Sahin, Gurdal and Turkbey, Baris and Elibol, Bulent},
abstractNote = {A 44-year-old male presented with multiple punctate acute infarcts of the vertebrobasilar circulation and a computed tomographic angiogram showing stenosis of the right vertebral origin. A digital subtraction angiogram demonstrated a new intraluminal filling defect at the origin of the stenotic vertebral artery where antegrade flow was maintained. This filling defect was accepted to be an acute thrombus of the vertebral origin, most likely due to rupture of a vulnerable plaque. The patient was treated with intravenous heparin. A control angiogram revealed dissolution of the acute thrombus under anticoagulation and the patient was treated with stenting with distal protection. Diffusion-weighted magnetic resonance imaging demonstrated no additional acute ischemic lesions. We were unable to find a similar report in the English literature documenting successful management of an acute vertebral ostial thrombus with anticoagulation. Anticoagulation might be considered prior to endovascular treatment of symptomatic vertebral stenoses complicated by the presence of acute thrombus.},
doi = {10.1007/S00270-006-0016-9},
journal = {Cardiovascular and Interventional Radiology},
number = 2,
volume = 30,
place = {United States},
year = {Sun Apr 15 00:00:00 EDT 2007},
month = {Sun Apr 15 00:00:00 EDT 2007}
}