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BMJ Case Reports 2014; doi:10.1136/bcr-2014-011114
  • CASE REPORT

Optical coherence tomography of the intracranial vasculature and Wingspan stent in a patient

  1. Marco A Costa3
  1. 1Neurosurgical Associates, Baptist Health Lexington, Lexington, Kentucky, USA
  2. 2Department of Neurosurgery, Baptist Health Lexington, Lexington, Kentucky, USS
  3. 3Department of Cardiology, Case Western University, Cleveland, Ohio, USA
  4. 4Department of Cardiology, Baptist Health Lexington, Lexington, Kentucky, USA
  1. Correspondence to Dr Curtis Alden Given II, Neurosurgical Associates, Baptist Health Lexington, 1760 Nicholasville Rd, Suite 301, Lexington, KY 40503, USA; cgiven{at}bhsi.com
  • Accepted 21 April 2014
  • Published 16 May 2014

Summary

A 67-year-old man with medically refractory vertebrobasilar insufficiency and short segment occlusions of the intracranial vertebral arteries was treated with angioplasty and stent placement. Fifteen hours after the procedure the patient developed symptoms of posterior fossa ischemia and repeat angiography showed thrombus formation within the stent which was treated with thrombolytic and aggressive antiplatelet therapy. Angiography revealed lysis of the clot, but concerns regarding the mechanism of the thrombotic phenomenon prompted frequency-domain optical coherence tomography (FDOCT) assessment. FDOCT provided excellent visualization of the stent and vessel wall interactions, as well as excluding residual flow-limiting stenosis, obviating the need for further intervention. The potential utility of FDOCT in the evaluation of intracranial atherosclerotic disease and additional intracranial applications are discussed.

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