SynthesisBMC neurology2025
Spinal cord infarction following neurointerventional procedures in the posterior cerebral circulation: a case analysis and systematic literature review.
Synthesis in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Spinal cord infarction after stenting for symptomatic severe stenosis of the basilar artery: a case description and literature analysis.Quantitative imaging in medicine and surgery · 2025Article
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Abstract
backgroundSpinal cord infarction, though rare, represents a severe complication of neurointerventional procedures involving the posterior vertebrobasilar circulation.
methodsWe report the case of a 49-year-old male with acute basilar artery occlusion treated with staged endovascular therapy. Initial thrombectomy and balloon angioplasty successfully restored basilar artery flow. However, drug-coated balloon angioplasty for residual basilar artery stenosis on the second procedure triggered cervical spinal cord infarction. Based on this case, we conducted a systematic literature review to identify cases of spinal cord infarction following posterior circulation neurointerventions and investigate potential underlying mechanisms.
resultsAmong the 18 included studies and our own case report, 28 cases was identified. The mean age of the patients was 59 years, with a male predominance. Clinical manifestations and outcomes varied considerably depending on the level and laterality of spinal cord involvement. Procedure-induced hemodynamic insufficiency in the vertebral artery during neurointerventional procedures was identified as the primary mechanism (17 cases, 60.7%), followed by perioperative direct spinal artery occlusion (6 cases, 21.4%). Other potential contributing factors included systemic hypotension, inadequate antithrombotic management, stent-induced microthrombosis, and prolonged procedural duration.
conclusionClinicians must recognize hemodynamic hypoperfusion of spinal cord arteries due to vertebral artery flow disruption as a critical mechanism of this complication. Preoperative assessment of cervical spinal cord hemodynamic vulnerabilities, intraprocedural utilization of small-diameter catheters, and prompt management of vertebral artery flow stagnation are all important measures to mitigate the risk of spinal cord infarction.
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