American Journal of Neuroradiology 28:155-158, January 2007
© 2007 American Society of Neuroradiology
Case Report
INTERVENTIONAL
Heparin-Induced Thrombocytopenia in a Case of Endovascular Aneurysm Coiling
a From the Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India
Address correspondence to Vipul Gupta, MD, Department of Neuroradiology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India 110029; e-mail: vipulgupta25{at}yahoo.com
SUMMARY: We report a case of 46-year-old man who underwent endovascular coil embolization for left anterior inferior cerebellar and posterior inferior cerebellar aneurysms. During embolization of both aneurysms, thrombotic complications were observed along with a relative lack of response to heparin. Intra-arterial abciximab was used to recanalize an almost completely occluded posterior inferior cerebellar artery. A marked decrease in platelet counts was found soon after embolization, which normalized within a few days. Serologic tests confirmed heparin-induced thrombocytopenia. This syndrome should be considered in cases with thromboembolic complications during endovascular procedures, particularly in patients undergoing repeated heparin exposure. A sudden decrease in platelet counts and lack of response to heparin, manifested as a relative lack of increasing activated clotting time, should make one suspect this syndrome.