Endovascular Treatment of Internal Carotid Artery Pseudo-Aneurysm Presenting with Epistaxis

Abstract

<jats:p> Recurrent epistaxis is a rare presentation of internal carotid artery C4/C5 segment pseudo-aneurysm rupture. We describe a case of a traumatic internal carotid artery pseudo-aneurysm with recurrent epistaxis as a leading symptom that was finally managed with endovascular treatment with stent-assisted coil placement. Clopidogrel and acetylsalicylic acid orally were introduced in the therapy for further stent thrombosis prevention and epistaxis did not recur on six-month follow-up. Endovascular treatment with stent-assisted coil placement seems to be a good method for pseudo-aneurysm treatment while keeping the lumen of the parent artery patent. </jats:p>

Detection of traumatic internal carotid artery pseudoaneurysm by postmortem imaging

“…In the majority of cases, epistaxis occurs within 1 to 3 months of injury, although delays in the presentation of up to 40 years have been seen. [17] In the present case, had traumatic aneurysm been recognized early and endovascular interventional treatment given timely, including detachable balloon, micro-coil, endovascular stent, and so forth, [18][19][20] then it would not have resulted in death.…”

Endovascular management of a carotid aneurysm into the sphenoid sinus presenting with epistaxis

“…5 Thus, the occlusion needs to be stabilized by a stent that covers the aneurysm's neck and prevents the risk of revascularization. 9 This procedure has also been described for the successful management of post-traumatic carotid artery pseudo aneurysm, 10 even if one can question the efficiency of the coils in that case, as there is no real aneurysm wall.…”