Pipeline embolization device as primary treatment for cervical internal carotid artery pseudoaneurysms

Wang, Arthur; Santarelli, Justin; Stiefel, Michael F.

doi:10.4103/2152-7806.198730

Cited by 11 publications

(3 citation statements)

References 37 publications

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“…All included studies were case reports (n = 46) or case series (n = 21 single center; n = 1 multicenter). 11,13,15 -80 Overall, 162 patients underwent endovascular repair with stenting for either true or false ECAA. One study comprised 3 patients who underwent endovascular reconstruction with a flow-diverting pipeline embolization device.…”

Section: Resultsmentioning

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: Resultsmentioning

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 modality is applied with the goal of separating the pseudoaneurysm from its circulation and has been successfully described in the thyrocervical trunk using detachable coils [2,5]. Pseudoaneurysms in other areas of the vasculature have been treated with other endovascular methods such as with flow-diverting stents [7], Onyx [8], and NBCA [9]. NBCA was considered in our case as it is a permanent adhesive liquid embolic agent with a low viscosity that allows for deeper small vessel penetration and can be performed in a much quicker and less expensive manner than detaching several coils [9].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Pseudoaneurysm of the Ascending Cervical Artery Treated with N-butyl Cyanoacrylate Embolization: A Case Report and Review of the Literature

Karsonovich

Hawkins

Gordhan³

2019

Cureus

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Pseudoaneurysms of the thyrocervical trunk and its branches are commonly iatrogenic in nature; however, trauma is often an inciting mechanism. Open surgical repair was considered the main treatment modality until recent advances in endovascular therapy proved to be a viable treatment option. We report a case of a traumatic pseudoaneurysm arising from the ascending cervical artery with an associated arteriovenous fistula (AVF) that was treated using n-butyl cyanoacrylate (NBCA) embolization. The use of a liquid embolysate such as NBCA provided an efficient and effective means of achieving both pseudoaneurysm occlusion and AVF disconnection.

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“…These show superior results when compared to any other treatment modality. [5][6][7] Overall, FDS results are encouraging as they have been associated with up to 75% complete aneurysm occlusion in 1 year and 5% morbimortality. [8][9][10] Main complications are delayed aneurysm rupture, ischemic lesions as well as delayed parent vessel occlusion.…”

Section: Introductionmentioning

confidence: 94%

Virtual stenting of intracranial aneurysms: A pilot study for the prediction of treatment success based on hemodynamic simulations

Berg

Saalfeld²,

Janiga

et al. 2018

Int J Artif Organs

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Endovascular treatment of intracranial aneurysms using flow-diverting devices has revolutionized the treatment of large and complex lesions due to its minimally invasive nature and potential clinical outcomes. However, incomplete or delayed occlusion and persistent intracranial aneurysm growth are still an issue for up to one-third of the patients. We evaluated two patients with intracranial aneurysm located at the internal carotid artery who were treated with flow-diverting devices and had opposite outcomes. Both patients presented with similar aneurysms and were treated with the same device, but after a 1-year follow-up, one case presented with complete occlusion (Case 1) and the other required further treatment (Case 2). To reproduce the interventions, virtual stents were deployed and blood flow simulations were carried out using the respective patient-specific geometries. Afterward, hemodynamic metrics such as aneurysmal inflow reduction, wall shear stresses, oscillatory shear, and inflow concentration indices were quantified. The hemodynamic simulations reveal that for both cases, the neck inflow was clearly reduced due to the therapy (Case 1: 19%, Case 2: 35%). In addition, relevant hemodynamic parameters such as time-averaged wall shear stress (Case 1: 35.6%, Case 2: 57%) and oscillatory shear (Case 1: 33.1%, Case 2: 26.7%) were decreased considerably. However, although stronger relative reductions occurred in the unsuccessful case, the absolute flow values in the successful case were approximately halved. The findings demonstrate that a high relative effect of endovascular devices is not necessarily associated with the desired treatment outcome. Instead, it appears that a successful intracranial aneurysm therapy requires a certain patient-specific inflow threshold.

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Pipeline embolization device as primary treatment for cervical internal carotid artery pseudoaneurysms

Cited by 11 publications

References 37 publications

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Traumatic Pseudoaneurysm of the Ascending Cervical Artery Treated with N-butyl Cyanoacrylate Embolization: A Case Report and Review of the Literature

Virtual stenting of intracranial aneurysms: A pilot study for the prediction of treatment success based on hemodynamic simulations

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