Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Endovascular Treatment Using Graft-Stent for Pseudoaneurysm of the Cavernous Internal Carotid Artery

  • Ko, Jun-Kyeung (Department of Neurosurgery, School of Medicine, Pusan National University) ;
  • Lee, Tae-Hong (Department of Diagnostic Radiology, School of Medicine, Pusan National University) ;
  • Lee, Jae-Il (Department of Neurosurgery, School of Medicine, Pusan National University) ;
  • Choi, Chang-Hwa (Department of Neurosurgery, School of Medicine, Pusan National University)
  • Received : 2010.11.12
  • Accepted : 2011.07.01
  • Published : 2011.07.28
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Abstract

A 57-year-old man presented with a 2-day history of left oculomotor palsy. Digital subtraction angiography revealed a pseudoaneurysm of the left cavernous internal carotid artery (ICA) measuring $37{\times}32mm$. The pseudoaneurysm was treated with a balloon expandable graft-stent to occlude the aneurysmal neck and preserve the parent artery. A post-procedure angiogram confirmed normal patency of the ICA and complete sealing of the aneurysmal neck with no opacification of the sac. After the procedure, the oculomotor palsy improved gradually, and had completely resolved 3 months after the procedure. A graft-stent can be an effective treatment for a pseudoaneurysm of the cavernous ICA with preservation of the parent artery.

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References

  1. Ahn JY, Han IB, Kim TG, Yoon PH, Lee YJ, Lee BH, et al. : Endovascular treatment of intracranial vertebral artery dissections with stent placement or stent-assisted coiling. AJNR Am J Neuroradiol 27 : 1514-1520, 2006
  2. Alexander MJ, Smith TP, Tucci DL : Treatment of an iatrogenic petrous carotid artery pseudoaneurysm with a Symbiot covered stent : technical case report. Neurosurgery 50 : 658-662, 2002
  3. Arat A, Turkbey B, Cil BE, Canyigit M, Cekirge S : Emergent treatment of an Iatrogenic arterial injury at femoral puncture site With Symbiot self-expanding PTFE-covered coronary stent-graft. Australas Radiol 51 Suppl : B331-B333, 2007 https://doi.org/10.1111/j.1440-1673.2007.01849.x
  4. Bush RL, Lin PH, Dodson TF, Dion JE, Lumsden AB : Endoluminal stent placement and coil embolization for the management of carotid artery pseudoaneurysms. J Endovasc Ther 8 : 53-61, 2001 https://doi.org/10.1583/1545-1550(2001)008<0053:ESPACE>2.0.CO;2
  5. Celil G, Engin D, Orhan G, Barbaros C, Hakan K, Adil E : Intractable epistaxis related to cavernous carotid artery pseudoaneurysm : treatment of a case with covered stent. Auris Nasus Larynx 31 : 275-278, 2004 https://doi.org/10.1016/j.anl.2004.03.007
  6. Charbel FT, Gonzales-Portillo G, Hoffman W, Cochran E : Distal internal carotid artery pseudoaneurysms : technique and pitfalls of surgical management : two technical case reports. Neurosurgery 45 : 643-648; discussion 648-649, 1999 https://doi.org/10.1097/00006123-199909000-00043
  7. Chow MW, Chan DT, Boet R, Poon WS, Sung JK, Yu SC : Extrusion of a coil from the internal carotid artery through the middle ear. Hong Kong Med J 10 : 215-216, 2004
  8. Cox MW, Whittaker DR, Martinez C, Fox CJ, Feuerstein IM, Gillespie DL : Traumatic pseudoaneurysms of the head and neck : early endovascular intervention. J Vasc Surg 46 : 1227-1233, 2007 https://doi.org/10.1016/j.jvs.2007.08.021
  9. Eckert B, Thie A, Carvajal M, Groden C, Zeumer H : Predicting hemodynamic ischemia by transcranial Doppler monitoring during therapeutic balloon occlusion of the internal carotid artery. AJNR Am J Neuroradiol 19 : 577-582, 1998
  10. Fabian TC, Patton JH Jr, Croce MA, Minard G, Kudsk KA, Pritchard FE : Blunt carotid injury. Importance of early diagnosis and anticoagulant therapy. Ann Surg 223 : 513-522; discussion 522-525, 1996 https://doi.org/10.1097/00000658-199605000-00007
  11. Fiorella D, Albuquerque FC, Deshmukh VR, Woo HH, Rasmussen PA, Masaryk TJ, et al. : Endovascular reconstruction with the Neuroform stent as monotherapy for the treatment of uncoilable intradural pseudoaneurysms. Neurosurgery 59 : 291-300; discussion 291-300, 2006 https://doi.org/10.1227/01.NEU.0000223650.11954.6C
  12. Kadyrov NA, Friedman JA, Nichols DA, Cohen-Gadol AA, Link MJ, Piepgras DG : Endovascular treatment of an internal carotid artery pseudoaneurysm following transsphenoidal surgery. Case report. J Neurosurg 96 : 624-627, 2002 https://doi.org/10.3171/jns.2002.96.3.0624
  13. Leung GK, Auyeung KM, Lui WM, Fan YW : Emergency placement of a self-expandable covered stent for carotid artery injury during trans-sphenoidal surgery. Br J Neurosurg 20 : 55-57, 2006 https://doi.org/10.1080/02688690600601382
  14. Li MH, Li YD, Gao BL, Fang C, Luo QY, Cheng YS, et al. : A new covered stent designed for intracranial vasculature : application in the management of pseudoaneurysms of the cranial internal carotid artery. AJNR Am J Neuroradiol 28 : 1579-1585, 2007 https://doi.org/10.3174/ajnr.A0668
  15. Maras D, Lioupis C, Magoufis G, Tsamopoulos N, Moulakakis K, Andrikopoulos V : Covered stent-graft treatment of traumatic internal carotid artery pseudoaneurysms : a review. Cardiovasc Intervent Radiol 29 : 958-968, 2006 https://doi.org/10.1007/s00270-005-0367-7
  16. Origitano TC, al-Mefty O, Leonetti JP, DeMonte F, Reichman OH : Vascular considerations and complications in cranial base surgery. Neurosurgery 35 : 351-362; discussion 362-363, 1994 https://doi.org/10.1227/00006123-199409000-00001
  17. Saatci I, Cekirge HS, Ozturk MH, Arat A, Ergungor F, Sekerci Z, et al. : Treatment of internal carotid artery aneurysms with a covered stent : experience in 24 patients with mid-term follow-up results. AJNR Am J Neuroradiol 25 : 1742-1749, 2004
  18. Van Nieuwenhove Y, Van den Brande P, van Tussenbroek F, Debing E, von Kemp K : Iatrogenic carotid artery pseudoaneurysm treated by an autologous vein-covered stent. Eur J Vasc Endovasc Surg 16 : 262-265, 1998 https://doi.org/10.1016/S1078-5884(98)80230-X
  19. Zhuang Q, Buckman CR, Harrigan MR : Coil extrusion after endovascular treatment. Case illustration. J Neurosurg 106 : 512, 2007 https://doi.org/10.3171/jns.2007.106.3.512

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