Trapping with high-flow bypass for a traumatic giant pseudoaneurysm of the supraclinoid carotid artery in an adolescent: case report

Sun, Lei; Li, Meng; Zhang, Hongqi; Du, Juan; Li, Feng

doi:10.1007/s00381-011-1397-x

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…However, when insufficiency of the collateral flows occurs, which can involve intolerance of the BOT, EC-IC high-flow bypass is needed prior to aneurysm trapping to revascularize the ICA, which has been previously reported by several studies (10,11).…”

Section: Discussionmentioning

confidence: 91%

“…As the mainstream surgical treatment of intracranial aneurysms, clipping is an important method for treating TICAs (8,9). However, since it can compromise the artery wall's patency, clipping is sometimes impossible, and wrapping and trapping may be the only choice (10)(11)(12). Wrapping has a risk of recurrence and rupture (12), and trapping should always be combined with complicated bypass procedures (10,11).…”

Section: Introductionmentioning

confidence: 99%

“…However, since it can compromise the artery wall's patency, clipping is sometimes impossible, and wrapping and trapping may be the only choice (10)(11)(12). Wrapping has a risk of recurrence and rupture (12), and trapping should always be combined with complicated bypass procedures (10,11). Therefore, surgical treatment of TICAs is a great challenge for neurosurgeons due to its pathological complexity and frequent close relationship with the skull base (6).…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Traumatic Intracranial Pseudoaneurysms: A Single-Center Experience

et al. 2021

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Background and Purpose: As a rare lesion secondary to brain trauma, traumatic intracranial aneurysms (TICAs) lead to high mortality and morbidity, and multiple treatment modalities have been applied for TICAs. All patients diagnosed with TICAs in our institution from 2010 to 2020 were included in the report, and their clinical features, treatment, and outcomes are described in detail. The purpose of this study is to illustrate the characteristic of different therapeutic methods of TICAs, and focus on the endovascular treatment.Methods: A total of 20 patients were included in this study. The 3 patients who declined treatment all died. Five of the other 17 patients were treated surgically, including clipping, wrapping, and trapping with or without EC-IC high-flow bypass, with only 1 case of parent artery preservation. Twelve patients underwent endovascular treatment, including bare coil embolization (1 case), stent-assisted coiling (2 cases), balloon-assisted coils/Onyx glue embolization (1 case) and covered stents (8 cases), with only 1 case of parent artery sacrifice.Results: 20 patients were included in the present study with 17 males, and the mean of age on 27 years (IQR: 22, 44 years). Eight patients presented with epistaxis, followed by 5 patients with coma, 3 patients with visual defects and 2 patients with CSF leakage. There were 18 TICAs located at the internal carotid artery (ICA); The other 2 TICAs located at pericallosal artery and A1 segment anterior cerebral artery (ACA). One case of diplopia occurred due to sacrifice of the ICA. Occlusion of the ophthalmic artery occurred in 3 patients after placement of a covered stent, with 1 patient suffering an irreversible vision decrease. None of the other patients who underwent the treatment have experienced an aggravation of their symptoms since the treatment; During the imaging follow-up, 1 case of recurrence and 1 case of endoleak occurred in this case series.Conclusions: TICAs are associated with significant morbidity and mortality, and endovascular treatment has emerged as a valuable option, which may be promising to improve the clinical outcomes due to their advantages of preserving the parent artery if occlusion of the side branch artery can be avoided.

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Section: Discussionmentioning

confidence: 91%