This Article Full Text Full Text (PDF) All Versions of this Article: 34/7/1728    most recent 01.STR.0000078561.40741.B4v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Qureshi, A. I. Search for Related Content PubMed PubMed Citation Articles by Qureshi, A. I. Pubmed/NCBI databases Substance via MeSH

(Stroke. 2003;34:1728.)
© 2003 American Heart Association, Inc.

Editorial Comment

Editorial Comment—Thromboembolic Events During Neuroendovascular Procedures

Cerebrovascular Program, Department of Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey, Newark, New Jersey

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Thromboembolic and ischemic complications occur frequently during and after endovascular procedures because of associated arterial injury and the thrombogenic characteristics of arterial catheters, contrast agents, and implanted devices such as coils and stents.^1,2 With the growing use of endovascular procedures in neurosurgical practice, adequate knowledge of the basic pathophysiological and pharmacological principles that are involved is important.

When blood first contacts a foreign surface, the sequence of events initiated often ends in blood coagulation and thrombus formation.³ Initially, a thin layer of platelets and fibrinogen covers the surface of the foreign material. The magnitude of the initial reaction depends on the surface charge, chemical properties, and topographic features of the vascular device and the pattern of blood flow in the vicinity.^1,3 The basic equipment used during endovascular procedures includes angiographic catheters, guidewires, and microcatheters. Several investigators have suggested that vascular catheters used for diagnostic and therapeutic purposes are not biologically inert but may serve as nidi for thrombosis.^1,4 Anderson et al⁵ observed that guidewires (both stainless steel and Teflon-coated) also exhibited surface irregularities that promote platelet aggregation and fibrin deposition. Even contrast agents may promote clotting in catheters and syringes, placing patients at risk of thromboembolism.^1,6 Gasperetti et al⁶ observed that the use of nonionic contrast material during coronary angioplasty was associated with a higher risk of intravascular thrombosis.

Both coils and stents are intravascularly implanted devices that invoke thrombogenic responses when placed in vessels. The coils most commonly used in endovascular procedures are platinum Guglielmi detachable coils.⁷ The purpose . . . [Full Text of this Article]

This article has been cited by other articles:

				A. I. Qureshi Endovascular Revascularization of Symptomatic Acute Extracranial Internal Carotid Artery Occlusion Stroke, November 1, 2005; 36(11): 2335 - 2336. [Full Text] [PDF]