Russo Riccardo, Molinaro Stefano, Mistretta Francesco, Gava Umberto, Morana Giovanni, Peretta Paola, Del Borrello Giovanni, Zeppa Pietro, Bergui Mauro
Department of Neuroscience, Neuroradiological Unit, University of Turin, Azienda Ospedaliera Città della Salute e della Scienza Hospital, Turin, Italy.
Pediatric Neurosurgery Unit, Ospedale Infantile Regina Margherita, Azienda Ospedaliera Città della Salute e della Scienza Hospital, Turin, Italy.
Neuroradiol J. 2024 Nov 22:19714009241303122. doi: 10.1177/19714009241303122.
We herein report the case of a pediatric patient suffering from subarachnoid hemorrhage (SAH) due to a ruptured internal carotid artery (ICA) saccular aneurysm. Considering the unfavorable anatomy and irregular shape of the aneurysm, a flow diverter (FD) stent was positioned in addition to coils in an acute setting. Cangrelor (Kengreal, Chiesi, USA) IV bolus followed by maintenance IV infusion was administered in addition to ASA at the time of intervention. Transitioning from cangrelor to thienopyridine (clopidogrel) was done the day after the procedure without any ischemic or hemorrhagic complications. The patient was discharged symptom-free 24 days later. We discuss technical considerations focusing specifically on antiplatelet therapy management.
我们在此报告一例因颈内动脉（ICA）囊状动脉瘤破裂导致蛛网膜下腔出血（SAH）的儿科患者病例。鉴于动脉瘤的解剖结构不佳且形状不规则，在急性期除了使用弹簧圈外，还置入了血流导向（FD）支架。在介入治疗时，除了给予阿司匹林（ASA）外，还静脉推注坎格雷洛（Kengreal，美国基耶西公司），随后进行静脉维持输注。术后第一天从坎格雷洛转换为噻吩并吡啶类药物（氯吡格雷），未出现任何缺血或出血并发症。24天后患者无症状出院。我们讨论了技术方面的考虑因素，特别关注抗血小板治疗的管理。
