Supraclinoid Internal Carotid Artery Aneurysm: Iatrogenic Aneurysm of the Supraclinoid Internal Carotid Artery After Craniopharyngioma Resection; Treatment of an Unruptured Fusiform Aneurysm with a Cardiatis Flow Diversion Device; Technical Aspects, Follow-Up Results, and Literature Review

2020 ◽  
pp. 305-315
Author(s):  
D. Mauricio Alvarez ◽  
Rene Viso ◽  
Ivan Lylyk ◽  
Esteban Scrivano ◽  
Pedro Lylyk
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Fusiform Aneurysm ◽  
Technical Aspects ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Supraclinoid Internal Carotid Artery

scholarly journals Staged Multimodality Treatment of a Large Ruptured Fusiform Supraclinoid Internal Carotid Artery Aneurysm: Microsurgical Clip.assisted Endovascular Coiling

2017 ◽  
Vol 08 (04) ◽  
pp. 668-671 ◽  
Author(s):  
Dale Ding ◽  
Thomas J. Buell ◽  
Ching-Jen Chen ◽  
Daniel M. Raper ◽  
Kenneth C. Liu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Multimodality Treatment ◽  
Endovascular Coiling ◽  
Fusiform Aneurysm ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Supraclinoid Internal Carotid Artery

ABSTRACTIn the contemporary era of aneurysm management, large fusiform aneurysms presenting with subarachnoid hemorrhage (SAH) remain particularly challenging lesions to successfully manage. We describe a staged, multimodal treatment strategy for a 71-year-old patient who presented with a large ruptured fusiform aneurysm of the supraclinoid internal carotid artery (ICA) and a fetal posterior communicating artery which originated from the inferomedial aspect of the aneurysm. In the first stage, we performed a partial microsurgical clip reconstruction of the fusiform aneurysm and secured its rupture site, which was identified intraoperatively. This left two residual saccular components of the aneurysm, which were targeted with endovascular coiling in the same hospitalization after the patient had convalesced from the SAH and was beyond the vasospasm window. We believe that this combined approach of clip-assisted coiling can be employed instead of endovascular flow diversion or microsurgical bypass for appropriately selected patients with ruptured fusiform ICA aneurysms.

scholarly journals Mid-term follow-up of staged bilateral internal carotid artery aneurysm treatment with Pipeline embolization

2019 ◽  
Vol 25 (6) ◽  
pp. 664-670
Author(s):  
Juan G Tejada ◽  
Gloria VV Lopez ◽  
Jerry ME Koovor ◽  
Kalen Riley ◽  
Mesha Martinez
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Flow Diverter ◽  
Imaging Data ◽  
Carotid Artery Aneurysm ◽  
Common Location ◽  
Internal Carotid Artery Aneurysm

Background Endovascular treatment of large complex morphology aneurysms is challenging. High recanalization rates have been reported with techniques such as stent-assisted coiling and balloon-assisted coiling. Flow diverter devices have been introduced to improve efficacy outcomes and recanalization rates. Thromboembolic complications and in-device stenosis are certainly more worrisome when treatment of bilateral internal carotid arteries has been performed. This study aimed to report our experience with mid-term imaging follow-up of staged bilateral Pipeline embolization device placement for the treatment of bilateral internal carotid artery aneurysms. Methods We reviewed the clinical, angiographic, and follow-up imaging data in all consecutive patients treated with bilateral internal carotid artery aneurysms who underwent elective Pipeline embolization. Results Six female patients were treated, harboring a total of 13 aneurysms. Of these, 60% were asymptomatic. Diplopia and headache were the most common symptoms. The most common location was the paraclinoid segment (6/13), including by cavernous segment (4/13) and ophthalmic segment (2/13). Successful delivery of the device was achieved in 12 cases. Difficult distal access precluded the deployment of the device in one case. The treatment was always staged with at least eight weeks' difference between the two procedures. All aneurysm necks were covered completely. There were no periprocedural complications. Angiographic follow-up ranged between 3 and 12 months, and computed tomography angiogram follow-up ranged between 2 and 24 months. Complete aneurysm occlusion was achieved in all cases. Conclusion In our series, Pipeline deployment for the treatment of bilateral internal carotid artery aneurysms in a staged fashion is safe and feasible. Mid-term imaging follow-up showed permanent occlusion of all the treated aneurysms.

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