2023 Volume 45 Issue 5 Pages 401-406
Heparin is an essential drug that is widely used during endovascular treatment. A serious adverse reaction to this drug is heparin-induced thrombocytopenia (HIT), which is characterized by thrombocytopenia and a high risk of thrombosis. However, reports of HIT during neurointerventional surgery have been limited. Herein, we report a case of acute multiple cerebral thromboses due to HIT during coil embolization for a cerebral aneurysm. The patient was a 52-year-old woman with a left basilar artery–superior cerebellar artery (SCA) aneurysm. Coil embolization was performed with a balloon-assisted technique. After coil insertion, the final angiography showed occlusion of the right anterior inferior cerebellar artery and thrombi in the right SCA and left posterior cerebral artery. Once we suspected HIT, we immediately discontinued heparin and administered argatroban. However, multiple cerebral infarctions were detected by postoperative magnetic resonance imaging. Since delayed recognition and treatment of HIT could cause critical damage, we should be aware of the risk of HIT and begin treatment for HIT when performing an endovascular procedure.
