Sugrel therapy groupDecade of life 4th 6th Gender F M Process Stent assisted coiling of basilar apex Anx PED therapy of correct ICA Anx PED remedy of left cavernous carotid artery Anx Coiling of left superior cerebellar artery Anx Balloon angioplasty and stenting of appropriate ICA stenosis Balloon angioplasty and stenting of appropriate ICA stenosis Preprocedural antiplatelet therapy ASA 325 mg PO daily; prasugel 60 mg PO load ASA 325 mg PO every day; prasugrel 60 mg PO load ASA 325 mg PO every day; prasugrel 60 mg PO load ASA 325 mg PO daily; prasugrel 60 mg PO load ASA 325 mg PO day-to-day; prasugrel 60 mg PO load ASA 325 mg PO day-to-day; prasugrel 60 mg PO load Postprocedural antiplatelet therapy ASA 325 mg PO everyday; prasugrel ten mg PO every day ASA 325 mg PO every day; prasugrel 10 mg PO each day Prasugrel 10 mg PO daily ASA 81 mg PO every day; clopidogrel 75 mg PO every day; prasugrel 10 mg PO PPD 1e2 ASA 325 mg PO every day; prasugrel 10 mg PO every day ASA 325 mg PO daily; prasugrel ten mg PO everyday Complications Basilar artery perforation, SAH, IVH, hydrocephalus Correct cervical ICA perforation with neck hematoma; spontaneous flank, groin and scrotal hematomas Left frontal IPH; upper GI bleed requiring blood transfusion Proper cerebellar IPH38th 6thF F55th 6thM MEpistaxis requiring nasal packing Epistaxis requiring nasal packing and blood transfusionAnx, aneurysm; ASA, acetylsalicylic acid (aspirin); ICA, internal carotid artery; IPH, intraparenchymal hemorrhage; IVH, intraventricular hemorrhage; PED, pipeline embolization device; PO, orally; PPD, postprocedure day; SAH, subarachnoid hemorrhage.1403864-74-3 uses J NeuroIntervent Surg 2013;5:33743.Formula of Val-Cit-PAB-MMAE doi:10.1136/neurintsurg2012Clinical neurologyFigure 1 (A) Anteroposterior view with the cerebral vasculature following a left vertebral artery contrast injection.PMID:33751764 A large aneurysm at the basilar apex is visualized. (B) Active extravasation of contrast agent from the lateral wall from the basilar artery (denoted by arrowhead). (C) Repeat cerebral catheter angiogram with injection in the left vertebral artery displaying close to total aneurysm occlusion after endovascular coil embolization. (DeF) Serial sections from a noncontrast head CT displaying diffuse hyperdensity within the basilar cisterns, bilateral Sylvian fissures and intraventricular space with obstructive hydrocephalus.the internal carotid artery (figure 2D). The patient remained intubated and was transferred towards the intensive care unit. On PPD 2, he became hemodynamically unstable and was found to have a big rectus sheath and right groin hematoma (figure 2E). He was taken towards the operating room with vascular surgery for placement of a covered iliofemoral stent for hemorrhage manage. On PPD three, he was restarted on full dose aspirin and prasugrel. Precisely the same day, the patient was noted to become much less responsive, tachypneic and tachycardic. Chest CT demonstrated huge bilateral pulmonary emboli. He was started on a bivalirudin intravenous drip. He was extubated on PPD 5. Coumadin therapy was began for deep venous thromboses and pulmonary emboli. He was discharged to a rehabilitation facility on PPD 15 and had a meaningful neurological recovery.Case NoA woman in her sixth decade of life with a 10 year history of an asymptomatic left superior cerebellar artery aneurysm presented having a 2 month history of diplopia. Catheter angiography revealed a 12322 mm left superior cerebellar artery aneurysm (figure 4A). The patient was loaded with clopidogrel (300 mg orally) then started on complete dose aspirin and clopidogr.
