Endovascular treatment of posttraumatic pseudoaneurysm of the common carotid artery.

Diego Rojas,Luis Riera Del Moral,Luis Riera De Cubas,Stefan Stefanov,Jesús Álvarez

doi:10.1155/2015/427040

Abstract

Carotid artery injuries with pseudoaneurysm are uncommon but associated with central neurologic dysfunction. We present a case of posttraumatic pseudoaneurysm of the right common carotid artery treated by implantation of a covered stent. A 44-year-old woman with multiple injuries after fall from height presents a small dissection flap of the right common carotid artery (RCCA) on the initial computed tomography angiography (CTA). Fifteen days later a 10 mm pseudoaneurysm is observed on control CTA. We decided endovascular treatment. Through right femoral access with a long introducer sheath placed in the innominate artery, we implanted a covered stent Advanta V12 9 × 38 mm in the RCCA. The patient was discharged from the hospital with antiplatelet therapy without any neurological dysfunction and complete exclusion of the pseudoaneurysm. Use of covered stents has emerged as a safe and effective alternative to surgical repair of carotid injuries.

Highlights

Extracranial carotid artery pseudoaneurysms and aneurysms are extremely rare, altogether accounting for only 0.4–4% of all peripheral artery aneurysms [1, 2]
Because of the risk of rupture as well as the neurological sequelae caused by cerebral atheroembolism, surgical intervention is recommended for carotid artery pseudoaneurysms
Studies have demonstrated the incidence of carotid pseudoaneurysms ranging from 0.02% to 0.4% among all trauma patients [3]

Summary

Introduction

Extracranial carotid artery pseudoaneurysms and aneurysms are extremely rare, altogether accounting for only 0.4–4% of all peripheral artery aneurysms [1, 2]. Because of the risk of rupture as well as the neurological sequelae caused by cerebral atheroembolism, surgical intervention is recommended for carotid artery pseudoaneurysms. Studies have demonstrated the incidence of carotid pseudoaneurysms ranging from 0.02% to 0.4% among all trauma patients [3]. The anatomical location and the coexistence of lesions in other parts of the body make the diagnosis and treatment a challenge in trauma patients. Endovascular techniques with stent-graft exclusion have emerged as an efficient and safe alternative to open surgical resection [4]. We present a case of posttraumatic pseudoaneurysm of the right common carotid artery treated with endovascular stenting

Case Presentation

Findings

Discussion