Giant cervical internal carotid artery pseudoaneurysm in a child: endovascular treatment

2002 ◽  
Vol 44 (10) ◽  
pp. 864-867 ◽  
Author(s):  
Köroglu M. ◽  
Arat A. ◽  
Çekirge S. ◽  
Akpinar E. ◽  
Eryilmaz A. ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Internal Carotid ◽  
Artery Pseudoaneurysm ◽  
Cervical Internal Carotid Artery

scholarly journals Ruptured Petrous Carotid Pseudoaneurysm Due to Tuberculous Otitis: Endovascular Treatment

2006 ◽  
Vol 12 (1) ◽  
pp. 53-56 ◽  
Author(s):  
A.B. Yagci ◽  
F.N. Ardiç ◽  
I. Oran ◽  
F. Bir ◽  
N. Karabulut
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Unusual Case ◽  
Internal Carotid ◽  
Surgical Intervention ◽  
Imaging Findings ◽  
Parent Vessel ◽  
Detachable Balloon ◽  
Artery Pseudoaneurysm

We report the imaging findings and endovascular treatment in an unusual case of petrous internal carotid artery pseudoaneurysm due to primary tuberculous otitis. The aneurysm was recognized and ruptured during a surgical intervention for otitis. Successful endovascular treatment of the aneurysm was performed by occlusion of the parent vessel using detachable balloon and coils.

scholarly journals Management of acute ischemic stroke due to tandem occlusion: should endovascular recanalization of the extracranial or intracranial occlusive lesion be done first?

2017 ◽  
Vol 42 (4) ◽  
pp. E16 ◽  
Author(s):  
Leonardo Rangel-Castilla ◽  
Gary B. Rajah ◽  
Hakeem J. Shakir ◽  
Hussain Shallwani ◽  
Sirin Gandhi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Clinical Outcome ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
National Institutes Of Health ◽  
Present Treatment ◽  
Tandem Occlusion ◽  
Cervical Internal Carotid Artery

OBJECTIVE Acute tandem occlusions of the cervical internal carotid artery and an intracranial large vessel present treatment challenges. Controversy exists regarding which lesion should be addressed first. The authors sought to evaluate the endovascular approach for revascularization of these lesions at Gates Vascular Institute. METHODS The authors performed a retrospective review of a prospectively maintained, single-institution database. They analyzed demographic, procedural, radiological, and clinical outcome data for patients who underwent endovascular treatment for tandem occlusions. A modified Rankin Scale (mRS) score ≤ 2 was defined as a favorable clinical outcome. RESULTS Forty-five patients were identified for inclusion in the study. The average age of these patients was 64 years; the mean National Institutes of Health Stroke Scale score at presentation was 14.4. Fifteen patients received intravenous thrombolysis before undergoing endovascular treatment. Thirty-seven (82%) of the 45 proximal cervical internal carotid artery occlusions were atherothrombotic in nature. Thirty-eight patients underwent a proximal-to-distal approach with carotid artery stenting first, followed by intracranial thrombectomy, whereas 7 patients underwent a distal-to-proximal approach (that is, intracranial thrombectomy was performed first). Thirty-seven (82%) procedures were completed with local anesthesia. For intracranial thrombectomy procedures, aspiration alone was used in 15 cases, stent retrieval alone was used in 5, and a combination of aspiration and stent-retriever thrombectomy was used in the remaining 25. The average time to revascularization was 81 minutes. Successful recanalization (thrombolysis in cerebral infarction Grade 2b/3) was achieved in 39 (87%) patients. Mean National Institutes of Health Stroke Scale scores were 9.3 immediately postprocedure (p < 0.05) (n = 31), 5.1 at discharge (p < 0.05) (n = 31), and 3.6 at 3 months (p < 0.05) (n = 30). There were 5 in-hospital deaths (11%); and 2 patients (4.4%) had symptomatic intracranial hemorrhage within 24 hours postprocedure. Favorable outcomes (mRS score ≤ 2) were achieved at 3 months in 22 (73.3%) of 30 patients available for follow-up, with an mRS score of 3 for 7 of 30 (23%) patients. CONCLUSIONS Tandem occlusions present treatment challenges, but high recanalization rates were possible in the present series using acute carotid artery stenting and mechanical thrombectomy concurrently. Proximal-to-distal and aspiration approaches were most commonly used because they were safe, efficacious, and feasible. Further study in the setting of a randomized controlled trial is needed to determine the best sequence for the treatment approach and the best technology for tandem occlusion.

Endovascular recanalization of chronically occluded internal carotid artery

2020 ◽  
Vol 12 (10) ◽  
pp. 946-951 ◽  
Author(s):  
Federico Cagnazzo ◽  
Pierre-Henri Lefevre ◽  
Imad Derraz ◽  
Cyril Dargazanli ◽  
Gregory Gascou ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Conservative Treatment ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Internal Carotid ◽  
Random Effects Models ◽  
Endovascular Recanalization ◽  
Cervical Internal Carotid Artery ◽  
Treatment Related Mortality ◽  
Related Mortality

BackgroundIt is debated whether endovascular treatment is indicated for a symptomatic chronically occluded internal carotid artery (COICA).ObjectiveTo assess outcomes after endovascular treatment of COICA.MethodsWe performed a systematic search of three databases (PRISMA guidelines), including endovascular series of COICA. Outcomes were analyzed with random-effects models.ResultsWe included 13 studies and 528 endovascularly treated patients with COICA. Successful recanalization was 72.6% (347/528, 95% CI 65.4% to 79.9%, I2=68.9%). Complications were 18% (88/516, 95% CI 12.1% to 23.8%, I2=65%), with 5% (25/480, 95% CI 2% to 7%, I2=0%) of permanent events, and 9% (43/516, 95% CI 6% to 13%, I2=34%) of thromboembolisms. Treatment-related mortality was 2% (11/516, 95% CI 0.5% to 2.6%, I2=0%). Shorter duration of the occlusion was associated with higher recanalization: 80% (11/516, 95% CI 54% to 89%, I2=0%), 63% (33/52, 95% CI 49% to 76%, I2=0%), and 51% (18/35, 95% CI to 37% to 88%, I2=40%) recanalization rates for 1, 3, and >3 months occlusions, respectively. Complications were 6% (3/50, 95% CI 3% to 21%, I2=0%), 14% (4/27, 95% CI 5% to 26%, I2=0%), and 25% (13/47, 95% CI 10% to 30%, I2=0%) for 1, 3, and >3 months occlusions, respectively. Patient aged <70 years presented higher revascularization rates (OR=3.1, 95% CI 1.2 to 10, I2=0%, p=0.05). Successful reperfusion was higher (OR=5.7, 95% CI 1.2 to 26, I2=60%, p=0.02) and complications were lower (OR=0.2, 95% CI 0.6 to 0.8, I2=0%, p=0.03) for lesions limited to the cervical internal carotid artery compared with the petrocavernous segment. Successful recanalization significantly lowered the rate of thromboembolisms (OR=0.2, 95% CI 0.8 to 0.6, I2=0%, p=0.01) and mortality (OR=0.5, 95% CI 0.1 to 0.9, I2=0%, p=0.04), compared with conservative treatment.ConclusionsEndovascular treatment of COICA gives a 70% rate of successful recanalization, with 5% morbidity. Patients aged <70 years, lesions limited to the cervical internal carotid artery, and a shorter duration of the occlusion decreased the risk of complications. Successful recanalization of symptomatic lesions lowered by about 80% the likelihood of thromboembolisms, compared with medical management.

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