Fatal hemorrhage after attempted treatment of a basilar artery stenosis. Case report.
Gralla J., Rennie AT., Squire W., Rothwell PM., Kuker W.
Interventional treatment of severe intracranial stenoses using angioplasty and stent placement carries a significant risk of severe adverse events. These events are frequently caused by the intraarterial dilation but may also be precipitated by other causes related to the procedure. The authors describe a fatal subarachnoid hemorrhage during the treatment of a basilar artery (BA) stenosis caused by a vascular rupture distant from the site of angioplasty. After successful balloon dilation, an attempt to deploy a self-expanding stent failed due to the severe kinking of the stenotic segment of the BA. The angiogram performed during the intervention revealed a fatal rupture of the BA in a location not related to the angioplasty or guide wire tip. The technical aspects of the intervention are analyzed on the basis of the postmortem findings.