Embolization of intracranial aneurysms and sickle cell disease

Abstract

The association of intracranial aneurysms and sickle cell disease (SCD) has been described in the English-language literature. Treatment strategies have included angiography and craniotomy. However, with advancement of non-operative interventions, much controversy surrounds the treatment of these patients. Endovascular embolization has been used in many patients with cerebral aneurysms, but it had been reported in the literature in only two sickle cell patients. The authors present a case of endovascular embolization of multiple intracranial aneurysms in a patient with sickle cell anemia with good outcome. Am.

Cerebral haemorrhagic risk in children with sickle‐cell disease

“…On the other hand, surgery may be at risk in SCD because of increased skull vascularity, especially in moyamoya syndrome. In both treatment options, careful management of hydration status, total haemoglobin, and haemoglobin S levels is recommended . Patients 1 and 3 are the first reported successful coil embolization procedures in paediatric patients with SCD.…”

Intracranial stenting as monotherapy in subarachnoid hemorrhage and sickle cell disease

“…Additionally, intravascular procedures have their inherent risks which can be complicated further by the hypercoagulable state of SCD patients. Vicari et al 3 suggest that with adequate preoperative management, specifically exchange transfusion to reduce hemoglobin S, SCD patients can be treated safely with endovascular approaches. Newer endovascular technology is providing better treatment options for CIAs that pose higher morbidity with microsurgery 25.…”

“…They are implicated in 2% of cases of intracranial hemorrhage in this patient population 1. There is limited information regarding coiling and no previous reports of intracranial stenting for cerebral aneurysms in these patients 2 3…”

Treatment and prevention of stroke in children with sickle cell disease

“…Endovascular embolization is also a potential option in selected patients. However, it is recommended that patients receive transfusion preoperatively to reduce the proportion of HbS and thereby decrease the rate of perioperative complications [18,Class II]. There are data from a randomized controlled comparison of endovascular treatment to open clipping (International Subarachnoid Aneurysm Trial, although this study did not enroll patients with aneurysms and SCD) that support endovascular treatment of aneurysms in some settings [19].…”