Giant petrous carotid aneurysm: persistent epistaxis despite internal carotid artery ligation

Abstract

Some aneurysms are too large to be treated with endovascular occlusion techniques; in such cases, ligation of the parent vessel is indicated. However, our patient continued to experience persistent, mild epistaxis despite internal carotid artery ligation, as a result of the reperfusion phenomenon.

Treatment of Intracranial Aneurysms Using the Pipeline Flow-Diverter Embolization Device: A Single-Center Experience with Long-Term Follow-Up Results

“…38 However, the stability and effectiveness of PAO may not be absolute for the treatment of large/ giant ICA aneurysms; the aneurysms may still remain patent 6,39 or may even bleed in the follow-up after PAO 40,41 and mass effect symptoms may persist. 39,42 Moreover, due to flow change, de novo aneurysms may develop or existing aneurysms may enlarge after PAO.…”

Giant cavernous carotid artery aneurysm mimicking a fungal granuloma and presenting with massive epistaxis

“…This can be circumvented by a hypotensive challenge during the BTO; this reduces the risk of developing fresh neurological deficits by 5% 20. Occasionally, the aneurysm may continue to fill from cross-circulation across the anterior communicating artery of the circle of Willis as in the present case 11. This would mandate trap ligation of the parent vessel by clipping the supraclinoid ICA in addition to Hunterian ligation of the cervical ICA.…”

Ruptured Aneurysm in Sphenoid Sinus: Which Is the Best Treatment

“…Conservative management may be applied in the incidental cases; on the other hand, a treatment is advisable in ruptured aneurysms [1, 4]. The present case and other reports in the literature suggest that therapeutic success can be hard to reach in such patients [5]. …”