POST-ANGIOPLASTY COMPLICATIONS IN POSTERIOR FOSSA STROKE: STENT FRACTURE IN THE LEFT VERTEBRAL ARTERY

• DOI: https://doi.org/10.22533/at.ed.1594712401089

• Palavras-chave: Posterior Fossa Stroke; Vertebral Artery Stenosis; Drug-Eluting Stent; Stent Fracture; Restenosis

• Keywords: Posterior Fossa Stroke; Vertebral Artery Stenosis; Drug-Eluting Stent; Stent Fracture; Restenosis

• Abstract:

  Posterior fossa strokes account for 20% of ischemic strokes and present significant diagnostic and therapeutic challenges due to their anatomical complexity. The vertebral artery is crucial for the blood supply of the posterior fossa and cerebellum, making its stenosis a critical risk factor for recurrent strokes and significant neurological deficits. Objective: To report a rare case of vertebral artery stent fracture after angioplasty in an elderly patient with posterior fossa stroke. Case description: An 86-year-old man with hypertension presented with sudden dysarthria, right labial commissure deviation, and gait ataxia. Initial imaging revealed severe (90%) stenosis of the left vertebral artery ostium. Angioplasty with drug-eluting stent was performed without immediate complications. Follow-up imaging, however, showed severe (75%) restenosis associated with a stent fracture. Discussion: A Stent fractures, although rare, significantly impact the outcomes of endovascular treatment. Factors contributing to stent fractures include implantation technique, vessel stiffness, and stent design. This case highlights the importance of continuous monitoring and expert management to address complications such as restenosis and stent fractures, which can compromise cerebral blood flow and patient outcomes. Conclusion: The management of posterior fossa strokes with endovascular interventions is complex. The rare complication of stent fracture led to severe restenosis, emphasizing the need for vigilant post-procedural monitoring and personalized therapeutic strategies. Further studies are needed to understand the risk factors and develop preventive measures for stent fractures in intracranial procedures.