Endovascular management of a posttraumatic pseudoaneurysm of the common carotid artery with superselective coil embolization

Loffroy, Romaric; Gergelé, F.; Rao, Pramod; Geschwind, Jean-Francois H.

doi:10.1016/j.jvs.2010.02.026

Cited by 8 publications

(8 citation statements)

References 3 publications

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“…With development and gradual perfection in recent years, endovascular interventional therapy has been gradually taking the place of the traditional treatment methods for TICAP by virtue of its microtrauma and high recovery rate. This technique is the treatment of choice for TICAP; balloons and covered stents are frequently-used embolising materials (1)(2)(3)13,19,20).…”

Section: Resultsmentioning

confidence: 99%

“…Patients with TICAP present repeated epistaxis that is difficult to control, a condition that often leads to hemorrhagic shock or asphyxia and thus seriously threatens life. Endovascular interventional therapy is the main treatment method for TICAP nowadays, which involves the use of detachable balloons, microcoils, endovascular stents, and so on (13,19,20). To explore the diagnosis and treatment of TICAP primarily manifested by repeated epistaxis, we retrospectively studied 31 cases with TICAP, who were cared for over a 12-year period from 2000 to 2012.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and treatment of traumatic internal carotid artery pseudoaneurysm primarily manifested by repeated epistaxis

Chen¹,

Li²,

Xu³

et al. 2012

Turkish Neurosurgery

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AIm:The current study aims to explore the diagnosis and treatment of traumatic internal carotid artery pseudoaneurysm (TICAP) primarily manifested by repeated epistaxis. mAterIAl and methOds: Clinical data from 31 patients suffering from repeated epistaxis after trauma were retrospectively analyzed. All patients were diagnosed definitely with pseudoaneurysm at the internal carotid cavernous sinus segment by digital subtract angiography (DSA).results: Endovascular interventional therapy was performed for all the patients. 20 patients received direct occlusion of the parent artery by embolization with detachable balloons and the rest received covered stent implantation to cover the parent arterial tear. No death occurred. Epistaxis did not recur after operation.COnClusIOn: DSA is the gold standard for TICAP diagnosis. Endovascular interventional therapy is the treatment of choice for TICAP. Compared with internal carotid artery occlusion with balloons, covered stent implantation is a more valuable endovascular intervention method.KeywOrds: Epistaxis, Pseudoaneurysm, Traumatic, Angiography, Interventional therapy ÖZ AmAÇ: Bu çalışma temel olarak tekrarlanan epistaksisle ortaya çıkan travmatik internal karotid arter psödoanevrizmasının (TİKAP) tanı ve tedavisini incelemeyi amaçlamaktadır. yÖntem ve GereÇler: Travma sonrasında tekrarlanan epistaksisi olan 31 hastanın klinik verileri retrospektif olarak analiz edildi. Tüm hastalara dijital subtraksiyon anjiyografisi (DSA) yoluyla internal karotid kavernöz sinüs segmentinde psödoanevrizma şeklinde kesin tanı kondu. BulGulAr:Endovasküler girişimsel tedavi tüm hastalarda yapıldı. 20 hastada ayrılabilir balonlarla embolizasyon yoluyla ana arterde doğrudan oklüzyon yapılırken diğerlerinde ana arteriyel yırtığı örtmek üzere örtülü stent implantasyonu yapıldı. Herhangi bir ölüm olmadı. Ameliyattan sonra epistaksis tekrarlamadı. sOnuÇ: TİKAP tanısı için altın standart DSA'dır. Endovasküler girişimsel tedavi TİKAP için tercih edilen tedavidir. Balonlarla yapılan internal karotid arter oklüzyonuyla karşılaştırıldığında, örtülü stent implantasyonu daha değerli bir endovasküler girişim yöntemidir.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of traumatic internal carotid artery pseudoaneurysm primarily manifested by repeated epistaxis

Chen¹,

Li²,

Xu³

et al. 2012

Turkish Neurosurgery

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“…2,3 In our case, we considered an open approach to reconstruct the common carotid artery. The surgery included an anterior approach with a proximal and distal control and excision of the entire aneurysm with primary repair of the lateral laceration (which was 4 mm in size).…”

Section: Discussionmentioning

confidence: 99%

A giant common carotid artery pseudoaneurysm after penetrating injury

Zhou

Arous

et al. 2012

Journal of Vascular Surgery

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A 55-year-old man presented with an enlarging tender pulsatile mass over the right side of the neck. There was a history of an antecedent penetrating trauma by a pedicure knife with a small entry wound, which was debrided at a local hospital 1 week before this admission.A carotid artery computed tomography angiogram revealed a 5.5 ϫ 6.5 cm pseudoaneurysm of the right common carotid artery that was partially thrombosed (A and B; Cover). There was no evidence of fluid collection or edema that could indicate infection.On examination, the patient had hoarseness in his voice with an irritating cough with eating indicating that the aneurysm was most likely compressing the recurrent laryngeal nerve. DISCUSSIONTrue or false aneurysms of the carotid arteries are very rare entities. Most of the false aneurysms are iatrogenic due to attempted jugular venous catheter insertion or blunt carotid injuries. 1 Most of those aneurysms are detected very early because of their superficial location in the neck that is easily noticeable by the patient or the physician.Treatment options for carotid pseudoaneurysm include arterial reconstruction with a vein or prosthetic interpositional graft or an endovascular repair with a covered stent graft. 2,3 In our case, we considered an open approach to reconstruct the common carotid artery. The surgery included an anterior approach with a proximal and distal control and excision of the entire aneurysm with primary repair of the lateral laceration (which was 4 mm in size). There was no indication of infection, so no culture of this pseudoaneurysm was performed. The pseudoaneurysm was conformed by pathological examination. Postoperatively, the patient did quite well without any neurological sequelae. His tone of voice recovered back to normal and his irritating cough even disappeared. Follow-up computed tomography angiogram demonstrated resolution of the pseudoaneurysm with widely patent carotid

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“…Application of systemic anticoagulants (heparin, warfarin, and antiplatelets) can improve prognosis [3]. In patients for whom medical treatments were ineffective, direct surgical repair can be difficult due to the difficulty of distal end exposure, hence intervention using stenting and coil embolization treatment has been shown to be superior and achieve good results [4][5][6]. Patients with pseudoaneurysms caused by sharp injury to the carotid artery are usually unstable and sometimes demonstrate obvious symptoms of impeded respiratory tract, continuous enlargement of hematomas, and significant bleeding that require immediate surgical exploration.…”

Section: Pseudoaneurysm Treatmentmentioning

confidence: 99%

Treatment strategies for carotid artery penetrating injury: a case report and literature review

et al. 2017

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Background: The carotid artery is an important blood vessel in the human body. Its ruptures caused by accidents can be lethal cases without timely treatment. Currently, successful rescue cases have rarely been reported, hence we present the following case. Case presentation: A patient who was a 46-year-old male admitted due to left neck trauma that lasted almost a day. The CT angiography (CTA) of the neck showed two pseudoaneurysms: one on the anterior wall and one on the posterior wall of the carotid artery. In our case, we considered an open approach to reconstruct the carotid artery. After excision of the aneurysm, the internal carotid artery was stitched. Electrophysiological monitoring and shunt were used during the operation. The postoperative course was uneventful, and the patient remains free of symptoms. Conclusions: Many departments jointly and positive and effective surgical intervention are the key to reduce morbidity and mortality of carotid artery penetrating injury.

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Endovascular management of a posttraumatic pseudoaneurysm of the common carotid artery with superselective coil embolization

Cited by 8 publications

References 3 publications

Diagnosis and treatment of traumatic internal carotid artery pseudoaneurysm primarily manifested by repeated epistaxis

Diagnosis and treatment of traumatic internal carotid artery pseudoaneurysm primarily manifested by repeated epistaxis

A giant common carotid artery pseudoaneurysm after penetrating injury

Treatment strategies for carotid artery penetrating injury: a case report and literature review

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