• Lei Yi, Wenyuan Zhao, Timo Krings, Wei Wang, and Jincao Chen.
• Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
• World Neurosurg. 2019 Jul 1; 127: 326-329.

IntroductionStent thrombosis (ST) is a known complication after intracranial stent implantation. The pathophysiology of ST is multifactorial, and standardized treatments for ST remain uncertain.Case DescriptionA patient harboring an unruptured aneurysm of the posterior communicating segment of the left internal carotid artery was treated with stent-assisted coil embolization while on dual antiaggregation therapy. Despite adherence to medication, ST occurred 8 days after the intervention. Following tirofiban infusion, the thrombus dissolved and clinical symptoms improved. However, after tirofiban was stopped, the patient experienced again ischemic symptoms. The patient underwent high-flow extracranial-to-intracranial bypass with good patency of the graft and resolution of symptoms.ConclusionsIn case of refractory ST, high-flow extracranial-to-intracranial bypass proved to be in this case a feasible and effective rescue option.Copyright © 2019 Elsevier Inc. All rights reserved.

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