Pipeline embolization for recurrent vertebral artery thromboembolic events secondary to a misplaced pedicle screw

Anthony S. Larson, Anthony L. Mikula, Waleed Brinjikji, Giuseppe Lanzino

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Cervical spine instrumentation carries a risk of vertebral artery injury which can cause devastating neurological events. Flow diversion using the Pipeline embolization device (PED) is a commonly used endovascular modality that can treat various vessel wall abnormalities including aneurysms and arterial dissections. Case Description: We report the case of a 69-year-old female who presented with multiple cryptogenic strokes secondary to a vertebral artery irregularity from a misplaced pedicle screw. She continued having ischemic infarcts despite maximal medical therapy. The patient was successfully treated with the PED and has not had any further ischemic events at 1-year follow-up. Conclusions: To our knowledge, this is the first published case of a chronic vertebral artery abnormality secondary to a misplaced pedicle screw that was treated with flow diversion. This is likely a safe and effective treatment for this rare complication of pedicle screw placement.

Original languageEnglish (US)
Pages (from-to)1555-1558
Number of pages4
JournalNeurological Sciences
Volume42
Issue number4
DOIs
StatePublished - Apr 2021

Keywords

  • Dissection
  • Pedicle screw
  • Pipeline embolization
  • Stroke
  • Vertebral artery

ASJC Scopus subject areas

  • Dermatology
  • Clinical Neurology
  • Psychiatry and Mental health

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