Giang Tran: Residual Internal Carotid Artery Aneurysm After Flow-Diverter Stenting
Giang Tran, Senior Supplier Quality Engineer at Sentient Energy, shared a post on LinkedIn:
“Residual Internal Carotid Artery Aneurysm After Flow-Diverter Stenting
A follow-up case that highlights an important point in the management of intracranial aneurysms.
A patient presented with a residual internal carotid artery (ICA) aneurysm more than one year after flow-diverter stent placement.
Two possible factors may have contributed to persistent aneurysm filling:
- Persistent inflow from the ophthalmic artery Recanalization of flow from the ophthalmic artery into the aneurysmal sac may maintain blood flow within the aneurysm and limit progressive thrombosis.
- Prolonged dual antiplatelet therapy without follow-up adjustment The patient continued dual antiplatelet therapy after stent placement but did not return for follow-up to reassess and adjust the antithrombotic regimen.
The fundamental principle of flow diversion is to reduce intra-aneurysmal flow and promote progressive thrombosis and occlusion of the aneurysm. Persistent inflow and continued antiplatelet therapy may potentially interfere with this process.
This case reminds us that flow-diverter treatment does not end when the stent is deployed. Imaging follow-up and appropriate antithrombotic management remain essential parts of the treatment pathway.
Imaging: Brain CT angiography performed on NAEOTOM Alpha photon-counting CT
Phuong Dong General Hospital, Hanoi, Vietnam”
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