Endovascular treatment of extracranial carotid artery aneurysms using self-expandable covered stent grafts: A single center retrospective study

Gao, Peixian; Qi, Jiaxin; Wang, Mo; Li, Gang; Yang, Le; Dong, Dianning; Wu, Xuejun

doi:10.1177/1708538121990120

Cited by 5 publications

(5 citation statements)

References 22 publications

(65 reference statements)

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“…One of the key findings of our study was the successful use of covered stents in managing carotid artery injuries: five out of the six patients with CCA or ICA injuries were successfully treated with covered stents alone. This finding is supported by other research, which advocates the use of covered stents for their ability to seal arterial disruptions while preserving blood flow, thereby reducing the risk of stroke and other complications [9][10][11][12][13][14][15]. In one patient with CCF, balloon-assisted coil embolization was attempted but failed, and the ICA was sacrificed with multiple coils.…”

Section: Discussionsupporting

confidence: 65%

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Koh,

Choi,

Shin

et al. 2024

Medicina

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Background and Objectives: Traumatic vascular injuries of the head and neck pose significant treatment challenges due to the complex anatomy, diverse clinical presentation, and mostly emergent nature. Endovascular treatment increasingly complements traditional surgical approaches. This study aimed to report our 10-year experience in treating traumatic vascular injuries of the head and neck with endovascular therapy and to determine the effectiveness of endovascular treatment. Materials and Methods: A retrospective analysis of 21 patients treated for head and neck vascular injuries between May 2011 and April 2021 was performed. Patients’ medical histories, clinical presentations, imaging findings, treatment materials, and clinical outcomes were reviewed. Treatments included stenting, coil embolization, and other endovascular techniques focused on hemostasis and preservation of the parent vessel. Results: The most common injuries involved the internal maxillary artery branches (n = 11), followed by the common or internal carotid artery (n = 6), vertebral artery (n = 3), and others. Endovascular treatment achieved successful hemostasis in all but one case. In five of six carotid artery injuries and two of three vertebral artery injuries, we achieved successful hemostasis while preserving the parent vessel using covered and bare stents, respectively. Conclusions: Endovascular therapy might be a useful treatment modality for traumatic vascular injuries in the head and neck region, offering efficacy, safety, and a minimally invasive approach.

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Section: Discussionsupporting

confidence: 65%

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Koh,

Choi,

Shin

et al. 2024

Medicina

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“…5 Covered stent grafts have been documented for the treatment of complex carotid artery lesions. [6][7][8][9][10][11] They not only provided immediate obliteration of the lesion but also preserved the normal lumen of the parent artery and promoted the growth and coverage of new endothelial cells 12 ; nevertheless, the challenges of thrombosis, stenosis, and the vessel structure may restrict the implantation. 13 The optimal endovascular treatment strategy for complex carotid artery lesions is yet to reach consensus.…”

Section: Introductionmentioning

confidence: 99%

Application of covered stent graft in the treatment of complex carotid artery lesions: A single center experience

et al. 2021

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Purpose To assess the clinical efficiency and imaging outcome of applying covered stent grafts for the treatment of complex carotid artery lesions. Method A total of 39 consecutive patients with carotid artery lesions treated with covered stent grafts at our institution from December 2016 to December 2019 were reviewed. Two kinds of stent including self-expandable covered stent (Viabahn; W. L. Gore & Associates) and balloon-expandable covered stent (Willis; Microport) were applied. The angiograms immediately after the procedure, perioperative complications, and follow-up outcomes were recorded. Result Based on imaging features, 11 patients exhibited pseudoaneurysms, 23 patients had blood blister-like aneurysms (BBAs), and five patients were carotid cavernous fistulas. A total of 40 stent implantations were performed, including nine Viabahn stents and 31 Willis stents. Two patients received double implants of Willis stents. Stent failed to perform for one patient due to tortuous parent artery. The angiography reports immediately after the procedure showed that the lesions in 36 patients were completely occluded, whereas two patients had minimal endoleaks. With respect to the occurrence of procedural complications, an aneurysm ruptured during the procedure in one case, which resulted in CCF, and acute in-stent thrombosis occurred in another case. Clinical and angiographic follow-up (11.2±2.4 months) sessions were conducted for 38 patients and a complete lesion exclusion was achieved in 36 patients. The minimal endoleak persisted in one patient and another patient experienced recurrence with stent migration, leading to ipsilateral blepharoptosis. However, none of the patients developed hemorrhage or ischemia and in-stent stenosis was not observed. Conclusion Covered stent grafts appear to be a safe and feasible for the treatment of complex carotid artery lesions. Despite the potential for stent delivery failure as well as endoleak and procedure-related complications, covered stent grafts should be considered when selecting the optimal treatment strategy.

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“…Several reports of stent placement for ECAAs have been published. 6 , 9 , 10) However, only one report has described treatment with two double-layer micromesh stents. 11) In that case, overlapped double-layer micromesh stents induced complete occlusion of the aneurysm, while parent artery patency was preserved as our case.…”

Section: Discussionmentioning

confidence: 99%

“… 6 – 8 , 12) Coil embolization and stenting (bare stent, FD stent, and covered stent) have recently been reported as minimally invasive endovascular treatments made possible by technological developments, and their outcomes for ECAAs are reportedly superior to those of surgical treatment. 9 , 10 , 13) Covered stents are not currently approved in Japan, and bare stents cannot directly block blood flow into an aneurysm. Therefore, FD stents are desirable.…”

Section: Discussionmentioning

confidence: 99%

Overlapped Double-Layer Micromesh Stents for Giant Extracranial Internal Carotid Artery Aneurysm

Murakami

Toyota

Takahara

et al. 2023

JNET

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Objective Extracranial internal carotid artery aneurysms (ECAAs) are rare. We herein describe a case of overlapped stenting with two double-layer micromesh stents for a giant ECAA. Case Presentation A 73-year-old man presented to our hospital with an enlarged right posterior cervical mass. A right internal carotid artery (ICA) angiogram revealed a giant aneurysm of 50 × 60 mm. We chose a carotid double-layer micromesh stent for stenting. With the patient under general anesthesia, the first double-layer micromesh stent (CASPER Rx, 10 × 30 mm; Terumo, Tokyo, Japan) was deployed between the ICA distal to the aneurysm and the common carotid artery (CCA). The second stent was also deployed from a site more proximal than the first one. Ten coils were then placed from a microcatheter that had been placed in the aneurysm. A right CCA angiogram after the procedure revealed a flow-diversion effect for the aneurysm. The patient was discharged with no complications. At the 6-month follow-up angiogram, blood flow into the aneurysm had completely disappeared. Conclusion A flow-diversion effect using overlapped double-layer micromesh stents can result in thrombosis and healing of giant ECAAs.

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Endovascular treatment of extracranial carotid artery aneurysms using self-expandable covered stent grafts: A single center retrospective study

Cited by 5 publications

References 22 publications

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Application of covered stent graft in the treatment of complex carotid artery lesions: A single center experience

Overlapped Double-Layer Micromesh Stents for Giant Extracranial Internal Carotid Artery Aneurysm

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