Predictors of the Resolution of Cavernous Sinus Syndrome Caused by Large/Giant Cavernous Carotid Aneurysms After Parent Artery Occlusion with High-Flow Bypass

Kikkawa, Yuichiro; Kayahara, Tomomichi; Teranishi, Akio; Shibata, Aoto; Suzuki, Kaima; Kamide, Tomoya; Ikeda, Toshiki; Kurita, Hiroki

doi:10.1016/j.wneu.2019.08.059

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…About interventional therapy of CCAs, recently reported morbidity range 3.5% to 8.4%, complete aneurysm obliteration rate range 32% to 75%, regrowth rate range 12% to 23.6% 15–18 . Whereas bypass surgery recently reported morbidity range 4.8% to 12.5%, complete aneurysm obliteration rate range 94.7% to 100%, no regrowth 10,19,20 . Our morbidity, complete aneurysm obliteration rate, and regrowth rate is 7%, 100%, and 0%, respectively.…”

Section: Discussionmentioning

confidence: 65%

“…[15][16][17][18] Whereas bypass surgery recently reported morbidity range 4.8% to 12.5%, complete aneurysm obliteration rate range 94.7% to 100%, no regrowth. 10,19,20 Our morbidity, complete aneurysm obliteration rate, and regrowth rate is 7%, 100%, and 0%, respectively. In contrast, bypass surgery has the advantage of low rates of regrowth and high rates of complete aneurysm obliteration.…”

Section: Safety and Efficacy Of Bypass For Gccamentioning

confidence: 96%

“…Fourth, because of its good safety and effectiveness, bypass surgery has become an important means to treat GCCAs. 8,10,20 And the operative treatment does not pose a higher risk to patients than periodic monitoring.…”

Section: Treatment Strategy For Asymptomatic or Mild Symptomatic Gccasmentioning

confidence: 99%

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Bypass Surgery to Treat Giant Cavernous Carotid Artery Aneurysms

Sun

Zhang

Wang

et al. 2021

Journal of Craniofacial Surgery

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Section: Discussionmentioning

confidence: 65%

Section: Safety and Efficacy Of Bypass For Gccamentioning

confidence: 96%

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Bypass Surgery to Treat Giant Cavernous Carotid Artery Aneurysms

Sun

Zhang

Wang

et al. 2021

Journal of Craniofacial Surgery

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“…The procedure involves trapping or ligating the ICA. [3][4][5][6][7][8][9][10][11][12][13] At high-flow bypass surgery for blister-like ICA aneurysms, the ICA must be trapped. 3,9,11) However, it has been reported that ICA occlusion of the intracranial portion was not needed because most cavernous and para-clinoid giant aneurysms spontaneously thrombosed upon proximal ICA ligation in patients treated with a high-flow bypass using a radial artery (RA) graft.…”

Section: Introductionmentioning

confidence: 99%

Distal Endovascular Occlusion for Incomplete Occlusion of Cavernous Carotid Aneurysms after High-flow Bypass and Cervical Internal Carotid Artery Ligation

Ideguchi

Kim

Mizunari

et al. 2023

Neurol. Med. Chir.(Tokyo)

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Internal carotid artery (ICA) ligation for placing a high-flow extracranial-intracranial (EC-IC) bypass is used in patients with aneurysms on the cavernous portion of the ICA. Recanalization and rupture after proximal ICA ligation can occur. We present four patients who underwent endovascular distal ICA occlusion and report our surgical technique and treatment results. We ligated the ICA to place an EC-IC bypass using a radial artery (RA) graft. Failure to obtain spontaneous occlusion in the distal region required endovascular treatment an average of 219 days later. A guide catheter was placed in the common carotid artery, a guide or distal access catheter was introduced in the RA graft from the external carotid artery, and a microcatheter was navigated into the cavernous aneurysm through the RA graft. Using detachable coils, endovascular ICA occlusion was from just distal to the aneurysmal neck to a site proximal to the origin of the ophthalmic artery. Aneurysmal occlusion was completed by endovascular occlusion of the distal ICA. Complications were RA graft stenosis and transient consciousness disturbance due to local subarachnoid hemorrhage. Outpatient follow-up for a mean of 109.5 months revealed no recurrences. Distal occlusion of the ICA through the implanted RA graft is simple and presents a low risk for cerebral infarction due to thrombus formation during the procedure. To treat cavernous carotid aneurysms that do not disappear after placing the EC-IC bypass after ICA ligation at the aneurysmal neck, we offer our procedure as a treatment option.

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“…There is a high risk that symptoms caused by CCA may only partially resolve [7,8]. A wide variety of neurovascular options exist, ranging from open surgical approaches to endovascular treatment [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Management of Cavernous Carotid Artery Aneurysms: A Retrospective Single-Center Experience

et al. 2022

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Objective: While cavernous carotid aneurysms can cause neurological symptoms, their often-uneventful natural course and the increasing options of intravascular aneurysm closure call for educated decision-making. However, evidence-based guidelines are missing. Here, we report 64 patients with cavernous carotid aneurysms, their respective therapeutic strategies, and follow-up. Methods: We included all patients with cavernous carotid aneurysms who presented to our clinic between 2014 and 2020 and recorded comorbidities (elevated blood pressure, diabetes mellitus, and nicotine consumption), PHASES score, aneurysm site, size and shape, therapeutic strategy, neurological deficits, and clinical follow-up. Results: The mean age of the 64 patients (86% female) was 53 years, the mean follow-up time was 3.8 years. A total of 22 patients suffered from cranial nerve deficit. Of these patients, 50% showed a relief of symptoms regardless of the therapy regime. We found no significant correlations between aneurysm size or PHASES score and the occurrence of neurological symptoms. Conclusion: If aneurysm specific symptoms persist over a longer period of time, relief is difficult to achieve despite aneurysm treatment. Patients should be advised by experts in neurovascular centers, weighing the possibility of an uneventful course against the risks of treatment. In this regard, more detailed prospective data is needed to improve individual patient counseling.

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Predictors of the Resolution of Cavernous Sinus Syndrome Caused by Large/Giant Cavernous Carotid Aneurysms After Parent Artery Occlusion with High-Flow Bypass

Cited by 7 publications

References 22 publications

Bypass Surgery to Treat Giant Cavernous Carotid Artery Aneurysms

Bypass Surgery to Treat Giant Cavernous Carotid Artery Aneurysms

Distal Endovascular Occlusion for Incomplete Occlusion of Cavernous Carotid Aneurysms after High-flow Bypass and Cervical Internal Carotid Artery Ligation

Management of Cavernous Carotid Artery Aneurysms: A Retrospective Single-Center Experience

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