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Case report
Intracranial stenting as monotherapy in subarachnoid hemorrhage and sickle cell disease
  1. Asiri Ediriwickrema1,
  2. Theresa Williamson1,
  3. Ryan Hebert2,
  4. Charles Matouk2,
  5. Michele H Johnson3,
  6. Ketan R Bulsara2
  1. 1Yale University School of Medicine, New Haven, Connecticut, USA
  2. 2Section of Neurovascular Surgery, Yale Department of Neurosurgery, New Haven, Connecticut, USA
  3. 3Yale Department of Radiology, New Haven, Connecticut, USA
  1. Correspondence to Dr Ketan R Bulsara, Yale Department of Neurosurgery, Director of Neuroendovascular and Skull Base Surgery, 333 Cedar Street, TMP 4, New Haven, CT 06520, USA; ketan.bulsara{at}yale.edu

Abstract

Introduction Although there have been a few reports of coiling intracranial aneurysms in patients with sickle cell disease (SCD), there are no reports of intracranial stent placement in this patient population. A patient in whom stent placement was utilized as monotherapy to treat a blister-like aneurysm is described and the implications of SCD and endovascular treatment are discussed.

Case report A 37-year-old man with SCD presented with diffuse subarachnoid hemorrhage. Angiography confirmed a 2 mm irregular aneurysm on the posterior cerebral artery which was treated with an oversized Neuroform 3 stent that was placed across the aneurysm neck by the senior author (KRB). Follow-up CT angiography showed no residual aneurysmal filling. The patient was discharged home in a stable condition, and he continues to do well 4 weeks following the procedure with no recurrence of the aneurysm.

Discussion This report reviews hypercoagulability in SCD and the treatment options for intracranial aneurysms in patients with SCD. Additionally, the reported case suggests that intracranial stent placement may be a viable option for treating complex intracranial aneurysms in SCD patients.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The study had a Yale HIC exemption.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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