Traumatic Internal Carotid Artery Pseudoaneurysm Research Articles

Postimplantation Syndrome after Traumatic Internal Carotid Artery Pseudoaneurysm Repair with Stent

AbstractEndovascular repair of traumatic internal carotid artery pseudoaneurysm (TICAP) with covered stents represents a safe treatment with few complications. However, the presence of foreign material used to treat TICAP and blood clots in the excluded pseudoaneurysms can trigger an acute systemic inflammatory response syndrome called postimplantation syndrome (PIS). To the best of our knowledge, PIS is described only after abdominal aortic endovascular aneurysm repair. Here, we report the case of PIS in a young, healthy, polytraumatized female patient with TICAP treated with endovascular covered stent.

A Case of Traumatic Internal Carotid Artery Pseudoaneurysm Diagnosed by Massive Bleeding During Endoscopic Sinus Surgery

A Case of Traumatic Internal Carotid Artery Pseudoaneurysm Diagnosed by Massive Bleeding During Endoscopic Sinus Surgery

Pseudoaneurisma di origine traumatica localizzato in un seno sfenoidale fratturato

SUMMARYWe describe a case of traumatic intra-sphenoidal right internal carotid artery pseudoaneurysm lodged inside the fractured sphenoidal sinus that developed in a patient with a previous history of frontal and skull base fractures involving the sphenoid sinus and walls of the carotid canal, but with normal intracranial findings at early CT angiography. The patient presented two episodes of massive life-threatening delayed epistaxis before successful endovascular treatment combining the use of coils and an uncovered stent was instituted. This case report highlights that patients with head trauma who present sphenoid sinus fractures with or without massive epistaxis should be evaluated for the development of traumatic internal carotid artery pseudoaneurysm as soon as possible. If the first angiographic evaluation reveals normal findings, repeated epistaxis should prompt a second angiographic evaluation because psudoaneurysm takes time to develop. Early treatment with uncovered stent of the aneurysm can be a life-saving therapeutic approach.

Traumatic Pseudoaneurysm of Internal Carotid Artery presenting as Intractable Epistaxis in a Case of Maxillary Fracture

ABSTRACT Traumatic pseudoaneurysm of internal carotid artery is a rare complication of injury after craniomaxillofacial trauma. Delayed recurrent epistaxis after head and facial trauma is the most distinctive manifestation of traumatic internal carotid artery pseudoaneurysm. Epistaxis due to pseudoaneurysm of internal carotid artery is difficult to control, and may lead to hemor- rhagic shock or asphyxia and thus seriously threatens life. The purpose of this paper is to present a rare case of recurrent epistaxis secondary to ICA pseudoaneurysm following blunt maxillofacial trauma. Endovascular stenting was performed and the recurrent epistaxis was successfully arrested. How to cite this article Kumar D, Sahu GR, Kumar A, Mukherjee KK, Rattan V. Traumatic Pseudoaneurysm of Internal Carotid Artery presenting as Intractable Epistaxis in a Case of Maxillary Fracture. J Postgrad Med Edu Res 2015;49(1):49-51.

Traumatic Pseudoaneurysm of Internal Carotid Artery presenting as Intractable Epistaxis in a Case of Maxillary Fracture

ABSTRACT Traumatic pseudoaneurysm of internal carotid artery is a rare complication of injury after craniomaxillofacial trauma. Delayed recurrent epistaxis after head and facial trauma is the most distinctive manifestation of traumatic internal carotid artery pseudoaneurysm. Epistaxis due to pseudoaneurysm of internal carotid artery is difficult to control, and may lead to hemorrhagic shock or asphyxia and thus seriously threatens life. The purpose of this paper is to present a rare case of recurrent epistaxis secondary to ICA pseudoaneurysm following blunt maxillofacial trauma. Endovascular stenting was performed and the recurrent epistaxis was successfully arrested. How to cite this article Kumar D, Sahu GR, Kumar A, Mukherjee KK, Rattan V. Traumatic Pseudoaneurysm of Internal Carotid Artery presenting as Intractable Epistaxis in a Case of Maxillary Fracture. J Postgrad Med Edu Res 2014;48(2):100-102.

Diagnosis and treatment of traumatic internal carotid artery pseudoaneurysm primarily manifested by repeated epistaxis

The current study aims to explore the diagnosis and treatment of traumatic internal carotid artery pseudoaneurysm (TICAP) primarily manifested by repeated epistaxis. Clinical data from 31 patients suffering from repeated epistaxis after trauma were retrospectively analyzed. All patients were diagnosed definitely with pseudoaneurysm at the internal carotid cavernous sinus segment by digital subtract angiography (DSA). Endovascular interventional therapy was performed for all the patients. 20 patients received direct occlusion of the parent artery by embolization with detachable balloons and the rest received covered stent implantation to cover the parent arterial tear. No death occurred. Epistaxis did not recur after operation. DSA is the gold standard for TICAP diagnosis. Endovascular interventional therapy is the treatment of choice for TICAP. Compared with internal carotid artery occlusion with balloons, covered stent implantation is a more valuable endovascular intervention method.

Treatment of Traumatic Internal Carotid Artery Pseudoaneurysms With the Willis Covered Stent: A Prospective Study

To evaluate the efficacy of the Willis covered stent in the treatment of traumatic pseudoaneurysms of the internal carotid artery (ICA). Thirty-eight patients with traumatic head and neck injury underwent angiography. We evaluated 14 delayed pseudoaneurysms in 13 patients who underwent angiography after treatment with the Willis covered stent. Prospective data on the technical success, initial and final angiographic results, mortality, morbidity, and final clinical outcome were analyzed immediately after the procedure, at the time of discharge from the hospital, at 3 months, 6 months, and 12 months after the procedures, and yearly thereafter. The Willis covered stent placement was successful in all 14 pseudoaneurysms. The initial angiographic results showed complete exclusion in 9 patients with 10 aneurysms (71.4% [95% confidence interval {CI}: 44-98%]) and incomplete exclusion in 4 patients. The angiographic follow-up (mean, 15 months [95% CI: 9-20 months]; range, 3-36 months) findings exhibited a complete exclusion in 12 patients with 13 aneurysms (92.9% [95% CI: 77-108%]) and an incomplete exclusion in 1 patient and maintained patency of the ICA in all patients. The clinical follow-up (mean, 20 months [95% CI: 14-27 months]) findings demonstrated full recovery (11 patients), symptom improvement (1 patient), or no change in the symptoms (1 patient). No procedure-related complications or deaths occurred during follow-up. Treatment with the Willis covered stent provides a viable approach for patients with traumatic pseudoaneurysms of the ICA, maintaining patency of the ICA and thus leading to excellent clinical results. An expanded clinical experiences and a larger sample are needed.

Traumatic internal carotid artery injury treated with overlapping bare metal stents under intravascular ultrasound guidance

We report a case of traumatic internal carotid artery pseudoaneurysm near the skull base that was successfully treated with anticoagulation and antiplatelet therapy and two overlapping bare stents placed under intravascular ultrasound guidance. Although incomplete exclusion of the pseudoaneurysm was seen on completion angiography, follow-up computed tomography angiography revealed complete resolution of the treated lesion. The patient remains asymptomatic at the 18-month clinical follow-up. This case report illustrates a successful endovascular treatment of a complex traumatic pseudoaneurysm with bare metal stenting using intravascular ultrasound guidance.

Covered Stent-Graft Treatment of Traumatic Internal Carotid Artery Pseudoaneurysms: A Review

To review the literature concerning the management with placement of covered stent-grafts of traumatic pseudoaneurysms of the extracranial internal carotid artery (ICA) resulting from penetrating craniocervical injuries or skull base fractures. We have reviewed, from the Medline database, all the published cases in the English literature since 1990 and we have added a new case. We identified 20 patients with traumatic extracranial ICA pseudoaneurysms due to penetrating craniocervical injuries or skull base fractures who had been treated with covered stent-graft implantation. Many discrepancies have been ascertained regarding the anticoagulation therapy. In 3 patients the ICA was totally occluded in the follow-up period, giving an overall occlusion rate 15%. No serious complication was reported as a result of the endovascular procedure. Preliminary results suggest that placement of stent-grafts is a safe and effective method of treating ICA traumatic pseudoaneurysms resulting from penetrating craniocervical injuries or skull base fractures. The immediate results are satisfactory when the procedure takes place with appropriate anticoagulation therapy. The periprocedural morbidity and mortality and the early patency are also acceptable. A surveillance program with appropriate interventions to manage restenosis may improve the long-term patency.