CORRECTION OF THROMBOEMBOLIC COMPLICATIONS IN ENDOVASCULAR EMBOLIZATION

Abstract

Objective. To analyze the thromboembolic complications of endovascular neurosurgical operations and the results of their treatment. Materials and Methods: During the period from 2010 to 2014 in the Department of Vascular Surgery of the brain endovascular interventions performed in 2415 patients, 28 (1,16 %) of them developed thromboembolic complications. In order to restore patency of cerebral arteries of 22 patients underwent selective intra-arterial injection of the Actilyse drug, with thrombolysis supplemented by mechanical disruption of the thrombus. 6 patients performed trombekstraktsiya with intracranial self-expanding stent «Solitaire ™ FR Revascularization Device». Results. Complete recanalization was achieved in 25 (89,2 %) of the 28 cases acute thrombosis of intracranial arteries arising during endovascular surgery, in 3 cases there was a partial recanalization. Retromboz artery in one day was detected in 2 patients undergoing aneurysm embolization coils with stent-assistend. Both patients showed a lack of inhibition of platelet aggregation during treatment with dual antiplatelet therapy. There was not Hemorrhagic complications of fibrinolytic therapy. Conclusions. During the endovascular interventions to reduce the risk of thromboembolic complications requires careful preoperative preparation of the patient, assessment of the blood coagulation system and sensitivity to antiplatelet agents. Application of trombekstraktor and thrombolytic therapy to restore patency of intracranial arteries is effective (recanalization was achieved in 89,2 % of cases).