Stent-Supported Coil Embolization for Carotid Artery Pseudoaneurysm as a Complication of Endovascular Surgery-Case Report-

Abstract

A 57-year-old male presented with right amaurosis fugax and left transient ischemic attack caused by stenosis of the intracranial segment of the right internal carotid artery (ICA). Percutaneous transluminal angioplasty with stenting was successfully performed to dilate the stenosis. However, serial angiography revealed the development of a large pseudoaneurysm in the cervical ICA, probably as a result of carotid wall injury caused by the guiding catheter during the procedures. The patient underwent a second endovascular angioplasty. A Palmaz stent was placed across the aneurysm neck to stabilize the carotid wall. Guglielmi detachable coils were then inserted into the aneurysm cavity through the stent struts to successfully obliterate the aneurysm. Both the angiographical results and the patient's outcome were favorable. Stent-supported coil embolization is an effective and safe technique for medically refractory pseudoaneurysms, and may be a useful alternative to direct surgery.

Endovascular Strategies for Vertebrobasilar Dissecting Aneurysms

“…Endovascular treatment for dissecting aneurysms by using stents has been proposed, especially in patients with otherwise untreatable dissecting basilar arteries, internal carotid artery pseudoaneurysms, and dissecting VA aneurysms. [24][25][26][27][28][29][30][31][32][33][34][35][36][37] Although endovascular surgery by using stents is effective for dissecting lesions, it usually does not prevent rebleeding, 25 and rebleeding can occur after double-stent placement alone. 9 Recently, we performed stent-only or stent-assisted coil embolization in patients with symptomatic unruptured dissecting aneurysms, without consideration of the PICA relationship.…”

Cerebral Air Embolism and Vasospasm after Carotid Revascularization: A Case Report

“…Several rare complications have been reported during or a few days after CAS. A large pseudoaneurysm was found in the cervical ICA due to carotid wall injury caused by the guiding catheter during the procedures [5]. Partial opening of a carotid Wallstent was caused by displacement of its metal ring marker, which thus hindered complete expansion of the stent [6].…”

Resection of a recurrent cervical internal carotid artery pseudoaneurysm after failed endovascular therapy

“…The most frequent etiology is trauma. Other etiologies include upper respiratory tract infections,[ 17 ] prior radiation,[ 2 7 ] iatrogenic,[ 13 ] postoperative,[ 6 9 18 20 26 ] deep neck infection,[ 4 ] retropharyngeal abscess,[ 14 22 ] and invasive fungal sinusitis. [ 12 ] Endovascular therapy is the principal option for such lesions.…”