Treatment of a Recurrent Internal Carotid Artery Pseudoaneurysm with the Wallgraft Endoprosthesis

Sibtain, Naomi; Shah, Jharna N.; Johnson, Declan; Clifton, Andrew

doi:10.1177/159101990601200212

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…The literature provides one instance where a patient had recurrent left ICA pseudoaneurysm after coil embolization, which was performed 4 years prior to presentation. [ 24 ] Our patient exhibited recurrence 15 years after ICA occlusion. Endovascular therapy was no longer an appropriate option.…”

Section: Discussionmentioning

confidence: 84%

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

et al. 2016

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Background:Recurrence of a cervical internal carotid artery (ICA) pseudoaneurysm initially treated by endovascular means is rare. We report an instance where a patient returned with a recurrent, enlarging cervical ICA pseudoaneursym, 15 years after initial complete, endovascular occlusion of the ICA.Case Description:Patient is a 64-year-old male with a history of a right cervical ICA pseudoaneurysm diagnosed 15 years ago after a car accident. At the time, he received endovascular occlusion of his right ICA. Recent serial imaging demonstrated progressive enlargement of his pseudoaneurysm, up to 6 cm × 5 cm × 5.5 cm, without evidence of internal flow or extravasation. Due to dysphagia and hoarseness, resection of the pseudoaneurysm was recommended. Dissection occurred down to the lesion, where its borders were skeletonized. Its stump at the proximal ICA was mobilized and clamped; the lesion was incised and the existing thrombus, as well as the coil mass, was removed. The distal ICA appeared completely scarred with no retrograde filling. There were branches from the external carotid artery that appeared to supply the pseudoaneurysm. The scarred remnant of the distal ICA was sutured and the stump at the proximal ICA was ligated. Once hemostasis was obtained, closure occurred via anatomical layers. Postoperatively, the patient woke up well; at discharge, he exhibited no respiratory distress or dysphagia. At 5 months follow-up, a computed tomography angiography of the neck revealed no evidence for a residual pseudoaneurysm. He continues on lifelong aspirin.Conclusion:Recurrence of a cervical ICA pseudoaneursym is rare. We caution that such a clinical scenario is possible, even 15 years after endovascular occlusion of the ICA. Branches from the external carotid artery may feed the pseudoaneursym and cause recurrence. This mechanism has not been reported. Perhaps longer clinical follow-up is necessary, especially if endovascular therapy is the initial treatment option.

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Section: Discussionmentioning

confidence: 84%

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

et al. 2016

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“…However, there are opposite reports showing that ICA pseudoaneurysms may continue to opacify and enlarge after the procedure and suggesting that there is always a potential for pseudoaneurysm recanalization with bare stent implantation, even if it was combined with coil embolization [ 1 ]. Sibtain et al reported on a case of bilateral traumatic carotid artery pseudoaneurysms which were first treated by using coil embolization instead of covered stent grafts because of contraindicated antiplatelet theraphy at presentation [ 8 ]. But because of the recurrence of ICA pseudoaneurysm 3 months after coil embolization, definite treatment with Wallgraft endoprosthesis was introduced.…”

Section: Discussionmentioning

confidence: 99%

Covered Stent-Graft Treatment of a Postoperative Common Carotid Artery Pseudoaneurysm

Hekįmoğlu

2014

Pol J Radiol

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Background Extracranial carotid artery pseudoaneurysms are rare cases resulting from trauma, mycotic infection, head and neck carcinomas or complications related to their treatment. Trauma is the most common cause of carotid artery pseudoaneurysms. They can also present after surgery, most commonly following endarterectomy, which is a rare cause with an estimated incidence of 0.3–0.6%. Case Report A 26-year-old male patient was admitted with swelling in his left neck after left carotid endarterectomy. Angiography confirmed pseudoaneursym in the left carotid bulb and it was treated successfully with two heparin-bonded covered stent grafts. Conclusions Endovascular treatment of carotid pseudoaneurysms with covered stent-grafts is a safe and efficient method providing definitive arterial reconstruction. But series with longer follow-up periods are needed to evaluate patient compatibility to lifelong antiplatelet theraphy.

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Stenting for Traumatic Pseudoaneurysms of the Cervical Internal Carotid Artery: Case Report and Systematic Review

Payman,

Pecoraro,

Tsiang

et al. 2024

World Neurosurgery

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Treatment of a Recurrent Internal Carotid Artery Pseudoaneurysm with the Wallgraft Endoprosthesis

Cited by 3 publications

References 18 publications

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

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

Covered Stent-Graft Treatment of a Postoperative Common Carotid Artery Pseudoaneurysm

Stenting for Traumatic Pseudoaneurysms of the Cervical Internal Carotid Artery: Case Report and Systematic Review

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