Dual anti-platelet therapy (DAPT) is standard treatment for endoluminal stent insertion, and complete resistance to DAPT is rare. A case of in-stent thrombosis occurring three hours after stent-assisted coiling of ICA aneurysm is presented despite compliance with DAPT. Platelet function tests (PFT) revealed complete clopidogrel and prasugrel resistance.
BackgroundThere is increasing evidence to demonstrate the use and efficacy of venous sinus angioplasty in select patients with medically refractory idiopathic intracranial hypertension (IIH) and venous sinus stenosis. In patients with challenging venous access, transcranial access to the venous sinus may be required. MethodsWe describe the novel technique of open cranial access for venous sinus stenting and demonstrate that it is safe and effective in the appropriate candidate.Results and ConclusionTranscranial venous sinus stenting for IIH has not yet been described in the adult population. It utilises combined open and endovascular techniques, which are safe and effective where distal access is not feasible.
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