Intra-aneurysmal Coil Embolization for Large or Giant Carotid Artery Aneurysms in the Cavernous Sinus

Abstract

This study evaluated the effectiveness of intra-aneurysmal coil embolization for large or giant carotid artery aneurysms in the cavernous sinus in seven patients treated by intra-aneurysmal coil embolization from 2001 to 2010. Only one patient showed improved neurological symptoms caused by aneurysmal mass effect during the mean follow-up period of 53.4 ± 27.3 months. Neurological symptoms caused by the aneurysms remained unchanged in two patients, and deteriorated in four. Intra-aneurysmal coil embolization is not considered an effective treatment option for large or giant carotid artery aneurysms in the cavernous sinus.

Endovascular treatment of carotid cavernous aneurysms: Complications, outcomes and comparison of interventional strategies

“…Although results following treatment of aneurysms originating from the Circle of Willis have been extensively reviewed in the literature, rates of complications and outcomes following treatment of symptomatic CCA remain less clear. 1,2,[5][6][7][8][9][10][11][12][13][14][15] Additionally, improvements in technology have increased the number of treatment options for CCA. We review our experience with the endovascular treatment of CCA, assess results following intervention with endovascular coiling, stent assistance, or carotid deconstruction, and determine predictors of outcome.…”

Endovascular treatment of carotid-cavernous vascular lesions

“…These lesions usually affect patients in the 5th and 6th decades of life 20 , and are commonly manifested by CNs compressive symptoms 19 . In this sample, the mean age at symptoms presentation was 52.2 years 20,21 . If only the group of non-traumatic ICA patients was considered, the mean age was 54.4 years.…”

“…This is the most common presentation [19][20][21] . Thus, the patients According to Vasconcellos et al 20 , the most commonly encountered IcCAA symptoms were, in decreasing order of frequency: headache, diplopia due to CN IV dysfunction, retro-orbital pain, visual deficit and photophobia.…”

“…The treatment of IcCAA with ICA occlusion, although not the ideal option, is considered by many authors as the choice for this type of lesion 21 , with up to 90% improvement in the CNs compressive symptoms 21 .…”

Acute subdural hematoma caused by a ruptured cavernous internal carotid artery giant aneurysm following abducens nerve palsy: case report and review of the literature

“…In terms of endovascular therapy for a symptomatic cavernous ICA aneurysm, intraaneurysmal coil embolization, with or without stent assist, can seldom obtain complete improvement of the cavernous sinus syndrome [8]. Recently, a flow diverter stent has been reported to treat an unruptured giant symptomatic cavernous ICA aneurysm effectively [10]; however, early aneurysm rupture after treatment has been described [11].…”