Endovascular management of internal carotid artery pseudoaneurysms: Retrospective observational study

Endovascular Management of Internal Carotid Artery Pseudoaneurysm Secondary to Pediatric Deep Neck Space Infection: A Case Report and Review of Literature

“…9 Common organisms associated with this complication are Staphylococcus aureus and Streptococcus pyogenes. 3 The mechanism of pseudoaneurysm formation is secondary to infectious arteritis of vessel wall with involvement of vasa vasorum, which results in ischemic vessel wall damage, subsequent erosion, and rupture. 5 Children with extracranial ICA pseudoaneurysms usually present with painful pulsatile neck mass.…”

“…5,10 Surgery may also be technically difficult, especially in pseudoaneurysms near skull base and in small necks. 1,3 Endovascular strategies have a lower mortality rate (4.1%), lower risk of stroke (1.8%) and cranial nerve injury (0.5%), and shorter length of hospital stay. 6,10 Endovascular strategies include PAO, coiling of pseudoaneurysm, using bare metal stents with/without coils, covered stents/stent grafts, and flow diverters to exclude the pseudoaneurysm from circulation.…”

“…Risk of rupture is more common in pseudoaneurysms in children, as compared with adults and in pseudoaneurysms occurring secondary to trauma and infections with high mortality rates in children (as high as 54%). 3 11 Ultrasound is the initial imaging investigation of choice. Diagnosis is usually confirmed by CT angiography, though magnetic resonance angiography can be performed in older and cooperative children.…”

“…5 10 Surgery may also be technically difficult, especially in pseudoaneurysms near skull base and in small necks. 1 3…”

“…1 2 Main causes include trauma, iatrogenic causes, infections, and malignancies with infection and trauma being the most common causes in children. 3 4 Prompt diagnosis and management is vital, in view of life-threatening complications like fatal airway hemorrhage and stroke. 2 5 Endovascular management has become the preferred treatment strategy due to its minimally invasive nature and lower complication rates.…”