Single-stage endovascular treatment in patients with severe extracranial large vessel stenosis and concomitant ipsilateral unruptured intracranial aneurysm

Kaçar, Emre; Nas, Ömer Fatih; Erdoğan, Cüneyt; Hakyemez, Bahattin

doi:10.5152/dir.2015.15092

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…There are different treatment approaches for treatment of coexisting of extracranial large vessel stenosis and UIAs, but there is no definite consensus on the management of these coexistent pathology [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] .…”

Section: Discussionmentioning

confidence: 99%

“…According to different authors, the prevalence of such combination ranges from 1% to 14.2% of total number of patients with severe extracranial large vessel stenosis [1] , [2] , [3] , [4] , [5] , [6] . There are different approaches for treatment of extracranial large vessel stenosis and coexistent UIAs, such as initial treatment of the aneurysm before revascularization of the stenosis; single-stage endovascular treatment of both lesions; stenosis eliminating followed by treatment of the aneurysm, or without treating the aneurysm [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] . There are still no neither guidelines nor consensus on the management of these coexistent lesions.…”

Section: Introductionmentioning

confidence: 99%

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Endovascular treatment of patient with multiple extracranial large vessel stenosis and coexistent unruptured wide-neck intracranial aneurysm using a WEB device and Szabo-technique

Cherednychenko

Engelhorn

Miroshnychenko

et al. 2020

Radiology Case Reports

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The coexistence of severe extracranial large vessel stenosis and unruptured intracranial aneurysms is not rare. There are different treatment approaches for these conditions, such as initial treatment of the aneurysm before revascularization of the stenosis; single-stage endovascular treatment of both lesions; stenosis eliminating followed by treatment of the aneurysm, or without treating the aneurysm. But, taking into account the risk of aneurysm rupture on the one hand and the risk of ischemic stroke on the other, it is sometimes difficult to choose the right management strategy. Despite this fact, there are still no guidelines or consensus on the management of these coexistent lesions. The article describes a clinical case of endovascular treatment of multiple extracranial stenosis and coexistent unruptured wide-neck aneurysm of the middle cerebral artery. The endovascular treatment of the carotid stenosis and aneurysm using a woven endobridge device was performed in one session; endovascular treatment of vertebral artery stenosis with Szabo technique was performed in another session.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endovascular treatment of patient with multiple extracranial large vessel stenosis and coexistent unruptured wide-neck intracranial aneurysm using a WEB device and Szabo-technique

Cherednychenko

Engelhorn

Miroshnychenko

et al. 2020

Radiology Case Reports

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“…And no aneurysm ruptured during a 2-year follow-up period. In the previous literature, endovascular treatment of the carotid stenosis and coexistent UIAs by single-stage or by stages therapy has also been reported [9,[21][22][23][24]. Park et al [23] reported 17 patients with 21 aneurysms underwent single-stage CAS and coiling for ipsilateral aneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…Park et al [23] reported 17 patients with 21 aneurysms underwent single-stage CAS and coiling for ipsilateral aneurysms. Kaçar et al [24] reported 7 patients underwent single-stage endovascular treatment of severe extracranial large vessel stenosis and concomitant ipsilateral UIAs. Both the authors believed that a single-stage procedure was feasible and safe.…”

Section: Discussionmentioning

confidence: 99%

Three-Month Outcome of Carotid Artery Stenting in Patients with/without Coexistent Unruptured Intracranial Aneurysms

Yang

Wang

et al. 2020

Cerebrovasc Dis

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Introduction: Safety of carotid artery stenting (CAS) in patients having carotid stenosis with coexistent unruptured intracranial aneurysms (UIAs) is rarely reported. Thus, we studied the 3-month outcome of CAS in the presence of coexistent UIAs in our institution. Methods: A retrospective analysis of patients receiving CAS at our institution from September 2011 to December 2019 was carried out. Patients were stratified into 2 groups: group of CAS with UIAs (CAS-UIA) and group of CAS without UIAs (CAS). The main complications within 3 months after stenting were TIA, ischemic stroke, symptomatic intracranial hemorrhage (sICH), rupture of UIAs, and death. The baseline characteristics and complications of the 2 groups were compared. Results: Five hundred fifty-six patients (CAS, n = 468; CAS-UIA, n = 88) were included and 604 stenting procedures were performed. More patients had hypertension in the CAS-UIA group (87.5 vs. 73.7%, p = 0.006). There was no significant difference in TIAs, ischemic stroke, sICH, and death within 3 months after stenting between the CAS and CAS-UIA groups. None of the 113 coexistent UIAs detected in 88 patients had aneurysm rupture within 3 months after CAS. Conclusions: In our large cohort of CAS patients, coexistent UIAs are not uncommon. Stenting of a carotid artery in the presence of coexistent UIAs could be conducted safely. Together with 3-month dual antiplatelet therapy, CAS did not increase the rupture risk of the coexistent UIAs within 3 months.

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“…10 Park et al treated 17 patients with simultaneous approach, and they reported 2 procedure-related complications: acute in-stent thrombosis and premature aneurysmal rupture in the other. 12 Kaçar et al reported that initial placement of the stent was useful for decreasing the risk of embolic complications in their 7 patients treated with a single-stage endovascular method 13 (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Endovascular Treatment of Tandem Internal Carotid Lesions

Cvetić¹,

Dragaš

Colić³

et al. 2016

Vasc Endovascular Surg

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The incidence of concomitant extracranial carotid artery stenosis and ipsilateral intracranial carotid aneurysm has been reported to vary between 2.8% and 5%. These complex lesions may present a challenge for treatment decision-making. This case report describes an asymptomatic male patient with severe carotid bifurcation stenosis, coupled with an unruptured supraclinoid internal carotid aneurysm. Both lesions were treated simultaneously. Patient underwent carotid stenting followed by aneurysm coiling in the same setting without any complication.

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Single-stage endovascular treatment in patients with severe extracranial large vessel stenosis and concomitant ipsilateral unruptured intracranial aneurysm

Cited by 10 publications

References 29 publications

Endovascular treatment of patient with multiple extracranial large vessel stenosis and coexistent unruptured wide-neck intracranial aneurysm using a WEB device and Szabo-technique

Endovascular treatment of patient with multiple extracranial large vessel stenosis and coexistent unruptured wide-neck intracranial aneurysm using a WEB device and Szabo-technique

Three-Month Outcome of Carotid Artery Stenting in Patients with/without Coexistent Unruptured Intracranial Aneurysms

Simultaneous Endovascular Treatment of Tandem Internal Carotid Lesions

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