Nitinol Stenting in Post-Traumatic Pseudo-Aneurysm of Internal Carotid Artery
نویسندگان
چکیده
Background: A pseudoaneurysm of the internal carotid artery (ICA) at its cervicl part, is a rare and often lethal complication after cervical trauma. The treatment of choice is anticoagulation. Patients with a contraindication for anticoagulation or those who do not improve with standard treatment, warrant either a surgical repair or stent placement. Stent placement posses both short and long term risks such as immediate ischemic events, in-stent stenosis and stent breakage, thus the choice of stent type is critical. Advances in stent technology have made cervical stent placement a viable option. We report our experience with the LEO + (Balt Extrusion, Montmorency, France) nitinol flexible self expanding stent for post-traumatic ICA aneurysms. Methods: 5 patients suffering a post-traumatic cervical ICA pseudo-aneurysms refractory to standard treatment were treated with nitinol braided flexible self expanding stent. This stent has a shape memory and superelasticity virtues making it suitable. Diagnosis was made with CT angiography and confirmed by catheter angiography. All procedures were preformed under local anesthesia. Time between trauma and treatment ranged six days to over five years. Follow-up was performed by CT angiography or conventional angiography. Results: Five patients, having eight aneurysms were treated using 12 stents. In all cases, appropriate stent placement was achieved. No immediate or late complications, as well as no neurological sequele reported at 6 months. Radiological follow-up exams demonstrated complete pseudoaneurysm closure. Conclusion: Stent placement can be a safe and definitive treatment option for patients to conventional medical treatment.
منابع مشابه
Carotid angioplasty and stenting in a patient with high grade stenosis of Internal Carotid Artery associated with both vertebral arteries and contralateral carotid occlusion
Severe internal carotid artery (ICA) stenosis is a common cause of cerebrovascular accident (CVA) in middle-aged patients. Contralateral carotid occlusion (CCO) in patients with severe ICA stenosis is associated with high risk of CVA. Carotid endarterectomy (CEA) is associated with more complications in patients with CCO than those without CCO. In this study, we present the case of a 61-year-ol...
متن کاملTreatment of Post Traumatic Internal Carotid Artery Pseudo Aneurysm with Intravascular Coil Embolization
متن کامل
Endovascular stent-assisted angioplasty in the management of traumatic internal carotid artery dissections.
BACKGROUND AND PURPOSE The prognosis of traumatic dissection of the internal carotid artery is worse than for spontaneous dissections. Rapid stenting followed by antiplatelet therapy may prevent complications when anticoagulation therapy is not applicable. METHODS Patients with angiographically proven traumatic carotid artery dissection and hemodynamic significant hemispheric hypoperfusion, o...
متن کاملCavernous carotid artery pseudo-aneurysm treated by stenting in acromegalic patient.
We report on a case of endovascular management of pseudoaneurysm of the cavernous segment of the internal carotid artery with covered stent reconstruction. A 36 years-old woman with a history of previous transsphenoidal approach for pituitary macroadenoma and false aneurysma formation was studied in a protocol that included balloon test occlusion and cerebral blood flow evaluation. An endovascu...
متن کاملMassive epistaxis secondary to pseudoaneurysm of internal carotid artery.
Post-traumatic pseudoaneurysms of internal carotid arteries are uncommon. The patients may present with massive epistaxis due to rupture of the aneurysm into the sphenoid sinus. Early diagnosis and treatment is mandatory as the likelihood of exsanguinations increases with each subsequent episode of epistaxis. The clinical features of unilateral blindness and massive epistaxis after head injury ...
متن کامل