Stent-grafting for the Large Common Carotid Artery Aneurysm

Abstract

219 duced 10Fr long sheath type guiding catheter into the right femoral artery and navigated it proximal to the right CCA aneurysm. After systemic anticoagulation with heparin, we measured carefully the diameter of the aneurysm by IVUS (intra-vascular ultrasonography). Then, we navigated a microcatheter (RapidTransit, Cordis) inside the right CCA aneurysm through the left femoral artery for possible coil embolization. We successfully deployed a self-expandable stent-graft (PASSAGER 10 mm _ 40 mm, Boston Scientific) through the 10-Fr guiding sheath and dilated it sufficiently with an 8-mm balloon catheter. Immediately after post dilatation, the stent-graft was expanded enough to contact the CCA wall, and the aneurysm disappeared on angiograms. Therefore, we didn't perform coil embolization. Post-procedure carotid arteriography showed no visualization of the aneurysm. Three-month and twelve-month carotid ultrasonography and arteriography demonstrated complete obliteration and no recurrence of the right CCA aneurysm. DiscussionSpontaneous common carotid artery aneurysms are rare, and treatment strategy has not yet been established. In general, asymptomatic aneurysms should not necessarily be treated surgically.

Supra-aortic vessels aneurysms: Diagnosis and prompt intervention

“…19 The use of radiological modalities, especially computed tomography (CT), are essential both to confirm the diagnosis and to plan repair. [20][21][22][23] Surgical resection of the aneurysm followed by an interposition has been the standard treatment. 6,24,25 However, with the rapid evolution of endovascular techniques, novel approaches for the treatment of supra-aortic aneurysms have been described.…”