Cargando…
Interventional Distal Embolization before Corrective Cervical Spinal Surgery for Posttraumatic Vertebral Artery Occlusion: A Case Report and Review of the Literature
OBJECTIVE: A traumatic vertebral artery (VA) injury may result in serious cerebral infarction in the vertebrobasilar area. However, the approach to its diagnosis and the optimal treatment have not yet been established. We present a patient with traumatic occlusion of a unilateral VA due to the multi...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society for Neuroendovascular Therapy
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370999/ https://www.ncbi.nlm.nih.gov/pubmed/37502271 http://dx.doi.org/10.5797/jnet.cr.2020-0204 |
_version_ | 1785078059566628864 |
---|---|
author | Matsumoto, Shirabe Tagawa, Masahiko Inoue, Akihiro Takeba, Jun Watanabe, Hideaki Kunieda, Takeharu |
author_facet | Matsumoto, Shirabe Tagawa, Masahiko Inoue, Akihiro Takeba, Jun Watanabe, Hideaki Kunieda, Takeharu |
author_sort | Matsumoto, Shirabe |
collection | PubMed |
description | OBJECTIVE: A traumatic vertebral artery (VA) injury may result in serious cerebral infarction in the vertebrobasilar area. However, the approach to its diagnosis and the optimal treatment have not yet been established. We present a patient with traumatic occlusion of a unilateral VA due to the multiple cervical spine fractures who required decompression and fixation, in whom the injured VA was coil embolized distal to the occlusion prior to the cervical spine surgery. CASE PRESENTATION: A 47-year-old woman was injured in a car accident and, presented with C6-C7 superior articular process fractures and C2-C3 ossification of the posterior longitudinal ligament (OPLL) with sensory hypoesthesia and motor palsy of the left upper limb. MRA showed left VA occlusion and patent contralateral VA. DSA showed left VA occlusion from the origin to C5/6 and its antegrade flow by collateral orthodromic circulation from the muscular branches. To prevent vertebrobasilar infarction due to migration of the thrombus from the occluded VA which was recanalized by surgical fixation, distal coil embolization of the injured VA by navigating a microcatheter through the contralateral VA across the vertebrobasilar junction was performed. Neither ischemic events nor new neurologic symptoms occurred during follow-up. CONCLUSION: Preoperative coil embolization to a traumatic VA occlusion can be one of the therapeutic choices to prevent thromboembolic stroke after cervical spine surgery. When the proximal segment of the VA was injured and VA occluded from origin, this treatment strategy is feasible, safe, and effective. |
format | Online Article Text |
id | pubmed-10370999 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Japanese Society for Neuroendovascular Therapy |
record_format | MEDLINE/PubMed |
spelling | pubmed-103709992023-07-27 Interventional Distal Embolization before Corrective Cervical Spinal Surgery for Posttraumatic Vertebral Artery Occlusion: A Case Report and Review of the Literature Matsumoto, Shirabe Tagawa, Masahiko Inoue, Akihiro Takeba, Jun Watanabe, Hideaki Kunieda, Takeharu J Neuroendovasc Ther Case Report OBJECTIVE: A traumatic vertebral artery (VA) injury may result in serious cerebral infarction in the vertebrobasilar area. However, the approach to its diagnosis and the optimal treatment have not yet been established. We present a patient with traumatic occlusion of a unilateral VA due to the multiple cervical spine fractures who required decompression and fixation, in whom the injured VA was coil embolized distal to the occlusion prior to the cervical spine surgery. CASE PRESENTATION: A 47-year-old woman was injured in a car accident and, presented with C6-C7 superior articular process fractures and C2-C3 ossification of the posterior longitudinal ligament (OPLL) with sensory hypoesthesia and motor palsy of the left upper limb. MRA showed left VA occlusion and patent contralateral VA. DSA showed left VA occlusion from the origin to C5/6 and its antegrade flow by collateral orthodromic circulation from the muscular branches. To prevent vertebrobasilar infarction due to migration of the thrombus from the occluded VA which was recanalized by surgical fixation, distal coil embolization of the injured VA by navigating a microcatheter through the contralateral VA across the vertebrobasilar junction was performed. Neither ischemic events nor new neurologic symptoms occurred during follow-up. CONCLUSION: Preoperative coil embolization to a traumatic VA occlusion can be one of the therapeutic choices to prevent thromboembolic stroke after cervical spine surgery. When the proximal segment of the VA was injured and VA occluded from origin, this treatment strategy is feasible, safe, and effective. The Japanese Society for Neuroendovascular Therapy 2021-03-04 2021 /pmc/articles/PMC10370999/ /pubmed/37502271 http://dx.doi.org/10.5797/jnet.cr.2020-0204 Text en ©2021 The Japanese Society for Neuroendovascular Therapy https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Case Report Matsumoto, Shirabe Tagawa, Masahiko Inoue, Akihiro Takeba, Jun Watanabe, Hideaki Kunieda, Takeharu Interventional Distal Embolization before Corrective Cervical Spinal Surgery for Posttraumatic Vertebral Artery Occlusion: A Case Report and Review of the Literature |
title | Interventional Distal Embolization before Corrective Cervical Spinal Surgery for Posttraumatic Vertebral Artery Occlusion: A Case Report and Review of the Literature |
title_full | Interventional Distal Embolization before Corrective Cervical Spinal Surgery for Posttraumatic Vertebral Artery Occlusion: A Case Report and Review of the Literature |
title_fullStr | Interventional Distal Embolization before Corrective Cervical Spinal Surgery for Posttraumatic Vertebral Artery Occlusion: A Case Report and Review of the Literature |
title_full_unstemmed | Interventional Distal Embolization before Corrective Cervical Spinal Surgery for Posttraumatic Vertebral Artery Occlusion: A Case Report and Review of the Literature |
title_short | Interventional Distal Embolization before Corrective Cervical Spinal Surgery for Posttraumatic Vertebral Artery Occlusion: A Case Report and Review of the Literature |
title_sort | interventional distal embolization before corrective cervical spinal surgery for posttraumatic vertebral artery occlusion: a case report and review of the literature |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370999/ https://www.ncbi.nlm.nih.gov/pubmed/37502271 http://dx.doi.org/10.5797/jnet.cr.2020-0204 |
work_keys_str_mv | AT matsumotoshirabe interventionaldistalembolizationbeforecorrectivecervicalspinalsurgeryforposttraumaticvertebralarteryocclusionacasereportandreviewoftheliterature AT tagawamasahiko interventionaldistalembolizationbeforecorrectivecervicalspinalsurgeryforposttraumaticvertebralarteryocclusionacasereportandreviewoftheliterature AT inoueakihiro interventionaldistalembolizationbeforecorrectivecervicalspinalsurgeryforposttraumaticvertebralarteryocclusionacasereportandreviewoftheliterature AT takebajun interventionaldistalembolizationbeforecorrectivecervicalspinalsurgeryforposttraumaticvertebralarteryocclusionacasereportandreviewoftheliterature AT watanabehideaki interventionaldistalembolizationbeforecorrectivecervicalspinalsurgeryforposttraumaticvertebralarteryocclusionacasereportandreviewoftheliterature AT kuniedatakeharu interventionaldistalembolizationbeforecorrectivecervicalspinalsurgeryforposttraumaticvertebralarteryocclusionacasereportandreviewoftheliterature |