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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 05(03): 186-189
DOI: 10.1055/s-0041-1728988
Case Report

Posterior Circulation Intervention but Mind the Spinal Cord!

Shahyan Mohsin Siddiqui 
1   Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Chandrajit Prasad 
1   Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Hima Pendharkar
1   Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Indira Devi Bhagavatula
2   Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Karthik Kulanthaivelu 
1   Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Abstract

Spinal cord infarction (SCI), a rare complication following endovascular treatment of posterior circulation aneurysms, is infrequently recognized in the periprocedural period. We illustrate the same with digital subtraction angiography and diffusion-weighted magnetic resonance imaging in this series of two cases. Categorically, the anterior spinal artery was patent, post-procedure, in both instances. Likely, guiding catheter-induced local flow alterations initiates the pathogenesis. A subsequent insufficiency of radiculomedullary artery (RMA) reinforcements is the probable mechanism leading to hemodynamic compromise. Our observations further reiterate that periprocedural antiplatelet therapy is conceivably ineffective in preventing SCI. Besides, advanced age and uncontrolled hypertension could potentially exacerbate the periprocedural RMA compromise. Due vigilance is required to recognize this rare and potentially life-threatening complication in posterior circulation neurovascular intervention.

Keywords

posterior circulation endovascular intervention - spinal cord infarction


Publication History

Article published online:
26 October 2021

© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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