Open surgery versus endovascular approach in treatment of extracranial carotid artery aneurysms

Ni, Leng; Weng, Huiling; Pu, Zuo; Zheng, Yuehong; Liu, Bao; Ye, Wei; Zeng, Rong; Liu, Changwei

doi:10.1016/j.jvs.2017.08.093

Cited by 22 publications

(20 citation statements)

References 21 publications

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“…4,64,82 Improved surgical techniques have minimized the periprocedural mortality rates to 2.6% 2,90 ; however, the incidence of cranial nerve injury during open surgery still remains up to 26%. 11,[90][91][92][93] Moreover, in cases of highly positioned aneurysms, hostile neck due to previous surgeries or radiotherapy, patients with unstable circulation, and elderly patients with comorbidities, open repair of an ECAA might be challenging and has higher risk. 4 Hereby, Attigah et al provided a morphological classification of carotid aneurysms, suggesting that both high (type I) and very low (type V) positioned aneurysms might be more suitable for EVT.…”

Section: Discussionmentioning

confidence: 99%

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Giannopoulos

Trinidad

Aronow

et al. 2020

Vasc Endovascular Surg

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Objective: Both true and false extracranial carotid artery aneurysms (ECAA) are a potential source of morbidity and mortality. While ECAA have historically been treated surgically, endovascular reconstruction with stenting is an emerging treatment option. The aim of our study was to report clinical/radiologic outcomes following endovascular repair of ECAAs. Methods: A comprehensive systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Results: A total of 68 case reports and case series, comprising 162 patients, were included. Most patients presented with at least one symptom or sign related to the ECAA (89.5%; N = 145/162). In 42.6% (N = 69/162) and 46.3% (N = 75/162) of the cases polytetrafluoroethylene covered and uncovered stents were deployed respectively. Immediate post-procedural imaging demonstrated complete aneurysm exclusion in 86.4% (N = 140/162) of the cases and minimal filling of the aneurysm sack in 10.5% (N = 17/162) of all cases. Perioperative adverse event rates were 3.1% for stroke, 1.2% for transient ischemic attack (TIA) and 4.3% for mortality. During a mean follow-up of 21.8months, there were additionally observed one stroke, two TIAs and three deaths. Overall 88.6 % of the patients (N = 117/132) remained asymptomatic, partially recovered or at least did not suffer from new neurologic deficits during follow up, with no signs of stenosis or occlusion of the carotid artery. Conclusions: Endovascular stenting for the treatment of ECAAs is feasible with acceptable short- and long-term clinical and radiologic outcomes. Prospective real-world studies are needed to further validate the safety and the long-term patency of endovascular repair.

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Section: Discussionmentioning

confidence: 99%

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Giannopoulos

Trinidad

Aronow

et al. 2020

Vasc Endovascular Surg

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“…This minimally invasive approach has shown to have an overall favorable outcome with a success rate of 85%-89% and a reduction in the rate of perioperative complications and length of hospital stay. Although it has been associated with neurological complications (4.7%); stroke and transient ischemic attack (2.1% and 2.6% respectively) [ 13 - 14 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Management of Iatrogenic Injury to Vertebral Artery With Central Venous Catheter in a Critically Ill Patient

Rayes

Khattak

Qafani

et al. 2020

Cureus

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Vertebral artery (VA) injury during catheterization is quite rare given its anatomical position, but can be catastrophic when it is not discovered early on and managed accordingly. A multidisciplinary approach to the management of such injury has to weigh-in the benefits and risks of open surgery versus endovascular intervention. This can be done after thorough assessment of the patient’s condition and accessibility of the injured vessel. We report a case of a 90-year-old female admitted as a case of pneumonia associated with decreased level of consciousness. She acquired an iatrogenic injury due to insertion of central venous catheter (CVC) into her dominant right VA as confirmed via CT angiography (CTA). This case report aims to highlight the role of endovascular intervention in the acute management of VA injury in a critically ill patient.

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“…Extracranial carotid aneurysms and pseudoaneurysms are rare, making up less than 1% of all aneurysms 2 . As a result, the largest contemporary series are comprised mainly of open surgical repairs1, 3, 4; data on endovascular techniques have been limited to case series 5, 6. Reports on transradial strategies for carotid pseudoaneurysms are even less common, given that the transfemoral approach is the conventional access site for carotid stenting 7…”

Section: Discussionmentioning

confidence: 99%

Transradial stenting of a carotid pseudoaneurysm

Png

Faries

Han

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

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Open surgery versus endovascular approach in treatment of extracranial carotid artery aneurysms

Abstract: In this single-institutional experience, both operative and endovascular interventions for ECCAs provided acceptable early and 5-year results. The endovascular approach had significantly less cranial nerve injury and shorter length of hospital stay.

Cited by 22 publications

References 21 publications

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Acute Management of Iatrogenic Injury to Vertebral Artery With Central Venous Catheter in a Critically Ill Patient

Transradial stenting of a carotid pseudoaneurysm

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