Oral verapamil in the prevention of recurrent cerebral ischaemia due to post-stent vasospasm.

WHAT IS KNOWN AND OBJECTIVE: Endovascular embolization of basilar tip aneurysms (BTA) is performed to prevent rupture, but little is known regarding post-procedural vasospasm and its consequences. We relate management of post-procedural vasospasm found in cardiovascular literature on this rare post-procedural intracranial complication.

CASE DESCRIPTION: A 52-year-old man develops ischaemic strokes after undergoing posterior cerebral artery (PCA) stent-assisted coil embolization of BTA. Work-up suggested that vasospasm was the cause of his strokes.

WHAT IS NEW AND CONCLUSION: Vasospasm after intracranial stenting may share similar pathophysiological features to coronary stenting, resulting in ischaemia. Verapamil should be considered an empiric therapy in prevention of stent-related vasospasm.