Role of controlled anticoagulation in occlusion of vertebral arteries for the treatment of basilar artery giant aneurysms in children / 中国脑血管病杂志

ABSTRACT

Objective Toinvestigatetheroleofcontrolledanticoagulationinocclusionofvertebral arteriesforthetreatmentofgiantfusiformaneurysmsofthebasilartrunkinchildren.Methods The clinical data of 3 children with giant fusiform aneurysms of the basilar trunk were analyzed retrospectively. Three children underwent bilateral vertebral artery occlusion with endovascular intervention,and conducted controlled anticoagulation by intravenous infusion of heparin sodium (10-30 U/[kg·h])after procedure. Results Intheprocessofanticoagulation,2patientshadsomeseverebleedingcomplications,including epistaxis,gastrointestinal bleeding,and after transient cessation of anticoagulation,they had severe brainstem ischemic symptoms,including vomiting,hemiplegia,loss of consciousness and respiratory dysfunctions (one recovered after using low-molecular weight heparin and one died),another patient did not have any serious complicationsandwascuredafteradjustingtheanticoagulationstrategy.Conclusion Inthetreatmentof basilar artery trunk giant fusiform aneurysms in children through the bilateral vertebral artery occlusion,the controlled anticoagulation after procedure may reduce the occurrence of brain stem infarction and severe bleeding complications. It may be an important measure for improving the safety and effectiveness of bilateral vertebral artery occlusion.