Endovascular Treatment of Extracranial Internal Carotid Pseudoaneurysm: Description of Three Cases

Camilla Micieli,Luca Valvassori,Anna Mercuri,Fabio Baruzzi,Renzo Minotto,Andrea Giorgianni,Carlo Pellegrino

doi:10.1055/s-0036-1584168

Abstract

The aim of this study is to explore the possibility of endovascular treatment of internal carotid artery pseudoaneurysm (PSA). These lesions are difficult to treat with a surgical approach, especially if they are located extracranially and close to the skull base. Endovascular stent placement in symptomatic and unstable extracranial internal carotid PSA was found to be safe and effective. Depending on hemodynamic aspects, complete local exclusion of aneurysmal formation is achieved in few months. We present three patients with carotid dissection and PSA formation that have been successfully treated by stent placement.

Highlights

The aim of this study is to explore the possibility of endovascular treatment of internal carotid artery pseudoaneurysm (PSA)
We present three patients with carotid dissection and PSA formation that have been successfully treated by stent placement
After 6 months, Computed tomography (CT) angiography (CTA) showed pseudoaneurysm (PSA; 35 mm) at the C1 level of the right internal carotid artery (ICA); because the lesion was responsible for stroke, the decision to treat was made after the acute phase, and endovascular treatment was performed

Summary

Introduction

The aim of this study is to explore the possibility of endovascular treatment of internal carotid artery pseudoaneurysm (PSA) These lesions are difficult to treat with a surgical approach, especially if they are located extracranially and close to the skull base. Digital subtraction angiography (DSA) showed dissection and complete occlusion of the proximal extracranial tract of the right internal carotid artery (ICA) and a lack of flow in the ipsilateral MCA. After 6 months, CT angiography (CTA) showed pseudoaneurysm (PSA; 35 mm) at the C1 level of the right ICA; because the lesion was responsible for stroke, the decision to treat was made after the acute phase, and endovascular treatment was performed. The PSA was reduced but clearly visible, filling in the arterial phase after the stent placement, and final checks showed a regular flow in the ipsilateral carotid vessel. Subsequent CTA checks confirmed the correct exclusion of the PSA, as well as during 5-year follow-up

Objectives

Conclusion