Endovascular Treatment of a Traumatic Middle Cerebral Artery Pseudoaneurysm with the Pipeline Flex Embolization Device

Aljuboori, Zaid; Meyer, Kimberley; Ding, Dale; James, Robert F.

doi:10.1016/j.wneu.2019.10.008

Cited by 8 publications

(11 citation statements)

References 17 publications

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“…However, different experts hold a variety of opinions on surgical strategies for pseudoaneurysms. Direct clipping of the aneurysmal neck may not be feasible because of the lack of a true vessel wall that makes clipping threatening and challenging (9,45,53). It often results in aneurysm avulsion and intraoperative bleeding due to the high fragility of the pseudowall (22).…”

Section: Microsurgerymentioning

confidence: 99%

“…The advantage of selective pseudoaneurysm embolization is the preservation of the parent artery (Figure 2). However, pseudoaneurysm recurrence is still a major issue for patients treated with simple coiling (7,9,11,14,16,26,30,53,60,63). Due to coil impaction into the thrombus (14), flow pulsatility may force into the interstices of the coil mass and lead to recurrent bleeding (27).…”

Section: Endovascular Embolizationmentioning

confidence: 99%

“…It also provides a scaffold for endothelialization and reconstruction of the vessel wall. Previous studies have shown that pseudoaneurysms treated with flow-diverting stents have high complete occlusion rates and low complication rates ( 6 , 7 , 18 , 19 , 26 , 30 , 53 – 55 , 67 , 69 , 79 ). However, the main limitation of flow-diverting stents is delayed aneurysm obliteration due to a lack of immediate thrombosis.…”

Section: Managementmentioning

confidence: 99%

See 2 more Smart Citations

Intracranial Pseudoaneurysms: Evaluation and Management

Zheng

Lu²,

Shen

et al. 2020

Front. Neurol.

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Intracranial pseudoaneurysms account for about 1% of intracranial aneurysms with a high mortality. The natural history of intracranial pseudoaneurysm is not well-understood, and its management remains controversial. This review provides an overview of the etiology, pathophysiology, clinical presentation, imaging, and management of intracranial pseudoaneurysms. Especially, this article emphasizes the factors that should be considered for the most appropriate management strategy based on the risks and benefits of each treatment option.

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Section: Microsurgerymentioning

confidence: 99%

Section: Endovascular Embolizationmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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Intracranial Pseudoaneurysms: Evaluation and Management

Zheng

Lu²,

Shen

et al. 2020

Front. Neurol.

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“…Our case differs from the abovementioned cases in that it was performed in the terrain of a DC, utilizing the STA from the everted skin flap as the bypass donor. However, it has to be said that endovascular techniques are rapidly advancing, with Aljuboori et al [17] recently describing the treatment of a traumatic pseudoaneurysm caused by a gunshot wound, via the Pipeline Flex Embolization Device. In our case, an endovascular treatment strategy would have been possible by occluding the mother vessel.…”

Section: Discussionmentioning

confidence: 99%

Bypass Procedure Performed in the Field of a Decompressive Craniectomy in the Case of an MCA Dissecting Aneurysm: Case Report and Review of the Literature

et al. 2020

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Treatment of complex aneurysms often requires additional surgical tools including the use of the extra-intracranial (EC-IC) bypass. The following report depicts the utilization of the EC-IC bypass in treating a dissecting aneurysm several hours after a salvage emergent evacuation of an acute subdural hematoma via decompressive craniectomy (DC). Preserving the superficial temporal artery during the DC provided a donor artery for the bypass surgery.

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“…2 Therefore, PSA is difficult to manage by surgical clipping, mainly due to the friable nature, the fusiform morphology, and the lack of true neck. 3 Microsurgical treatment has transitioned to endovascular therapy for intracranial PSAs recently, improving parent artery preservation and decreasing morbidity and death rate. 4 In recent years, Willis covered stents (WCSs; MicroPort, China) have been considered a promising tool for treating intracranial PSAs.…”

Section: Introductionmentioning

confidence: 99%

Willis Covered Stent for Treating Intracranial Pseudoaneurysms of the Internal Carotid Artery: A Multi-Institutional Study

Lu¹,

Ma²,

Zhu³

et al. 2022

NDT

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This work aimed to retrospectively analyze Willis covered stent (WCS)'s therapeutic efficacy in intracranial pseudoaneurysms (PSAs) of the internal carotid artery (ICA). Methods: Between June 2018 and July 2021, 56 individuals with intracranial PSAs of the ICA treated with WCS in three centers were included to analyze information regarding medical records, operative parameters, imaging findings and follow-up data. Results: All WCSs were successfully targeted to the ICA lesions. Total exclusion of PSA was found in 53 cases (94.6%) right upon surgery, and mild endoleak into the aneurysm remained in 3 cases (5.4%). Intraoperative thrombosis occurred in 1 case (1.8%), and tirofiban was utilized for recanalization. Follow-up by angiography showed total aneurysm occlusion in the total number of individuals, including in the 3 above cases with residual endoleak. In-stent stenosis occurred in 7 (12.5%) patients. No stent-related ischemic event was encountered. Predictive factors of late in-stent stenosis following WCS implantation in this patient group were irregular post-operative antiplatelet treatment (p = 0.015) and C4-C5 segment of the ICA (p = 0.043). Conclusion: WCSs are effective in treating intracranial PSAs of the ICA.

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Endovascular Treatment of a Traumatic Middle Cerebral Artery Pseudoaneurysm with the Pipeline Flex Embolization Device

Cited by 8 publications

References 17 publications

Intracranial Pseudoaneurysms: Evaluation and Management

Intracranial Pseudoaneurysms: Evaluation and Management

Bypass Procedure Performed in the Field of a Decompressive Craniectomy in the Case of an MCA Dissecting Aneurysm: Case Report and Review of the Literature

Willis Covered Stent for Treating Intracranial Pseudoaneurysms of the Internal Carotid Artery: A Multi-Institutional Study

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