Cervical–petrous internal carotid artery pseudoaneurysm presenting with otorrhagia treated with endovascular techniques

Abstract

Cervical-petrous internal carotid artery (CP-ICA) pseudoaneurysms are rare and have different etiologies, presentations, and treatment options. A middle-aged patient with a history of chronic otitis media presented with acute otorrhagia and was found to have a left-sided CP-ICA pseudoaneurysm. The patient was a poor surgical candidate with difficult arterial access. The pseudoaneurysm was treated with stand-alone coiling via a left brachial approach with persistent contrast filling seen only in the aneurysm neck at the end of the procedure. The patient re-presented 12 days later with repeat hemorrhage and rapid enlargement of the neck remnant, and was treated with a covered stent via a transcervical common carotid artery cut-down. A covered stent may provide a more definitive treatment for CP-ICA pseudoaneurysms compared with standalone coiling.

A rare but morbid neurosurgical target: petrous aneurysms and their endovascular management in the stent/flow diverter era

“…Although their size and morphology can sometimes make them relatively challenging endovascular targets, the introduction of flow diversion has substantially augmented the endovascular library of creative approaches to these aneurysms 6 11 12. Nevertheless, their rarity has largely precluded analyses of their management in case series;6 even today, the treatment of these aneurysms is often described in case reports 13 14. We present a case series depicting our recent experience with petrous aneurysms in the era of dedicated intracranial stents and flow diverters.…”

Resection of a recurrent cervical internal carotid artery pseudoaneurysm after failed endovascular therapy

“…[ 21 ] If the patient fails the BTO, an extracranial–intracranial bypass is an option, which can be accompanied by surgical or endovascular entrapment. [ 15 ] Resection of the cervical ICA pseudoaneurysm followed by end-to-end anastomosis has also been implemented. [ 15 ]…”

“…[ 15 ] Resection of the cervical ICA pseudoaneurysm followed by end-to-end anastomosis has also been implemented. [ 15 ]…”

Pseudoaneurysm of the Petrosal Internal Carotid Artery in the Middle Ear as a Complication of Middle Ear Cholesteatoma

“…Although pseudoaneurysms of the petrous ICA have a number of different etiologies, this is the first report of a pseudoaneurysm caused by middle ear cholesteatoma. Cervical-petrous ICA aneurysms with a history of chronic otitis media have been reported previously [ 6 , 13 ]; however, a history of ear-pick trauma was reported in one case, and in the other case, iatrogenic injury cannot be ruled out owing to a history of tympanoplasty. We believe that, our patient was the first to present with spontaneous massive ear hemorrhage as a chief complaint.…”