Traumatic superficial temporal artery pseudoaneurysm: Successful management using endovascular embolization

Purpose To give an overview of the etiology and diagnostic process of superficial temporal artery pseudoaneurysms and to evaluate different treatment modalities. Basic methods PubMed was used for searching multiple databases for relevant clinical studies. Principal findings A total of 62 studies were included, harboring 82 patients. Surgical excision is the most frequently described treatment, but less invasive treatment modalities as coiling and thrombin injections are gaining popularity. Surgical treatment was successful in all cases (67/67). Endovascular treatment was successful in 69% (9/13); the five cases treated with thrombin injection were all successful. Complementary, a description of our experience with thrombin injection is given. Conclusions Limited evidence of minimal invasive treatment for superficial temporal artery pseudoaneurysm is available. Based on this review combined with our limited experience, we suggest thrombin injections to be considered as the future primary treatment modality. In the case of unsuccessful exclusion of the aneurysm, surgical excision can be performed.

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A Surgical Case of Delayed Coil Migration After Balloon-Assisted Embolization of an Intracranial Broad-Neck Aneurysm: Case Report

Operative Neurosurgery ◽

10.1227/neu.0b013e3181f82588 ◽

2010 ◽

Vol 67 (suppl_2) ◽

pp. onsE516-onsE521 ◽

Cited By ~ 4

Author(s):

Hiroaki Motegi ◽

Masanori Isobe ◽

Toyohiko Isu ◽

Hiroyasu Kamiyama

Keyword(s):

Coil Embolization ◽

Artery Bypass ◽

Superficial Temporal Artery ◽

Tension Headache ◽

Temporal Artery ◽

Carotid Bifurcation ◽

Endovascular Embolization ◽

Parent Artery ◽

Ischemic Attack ◽

Coil Migration

ABSTRACT BACKGROUND AND IMPORTANCE: Balloon-assisted coil placement is an important technique for coil embolization of broad-neck aneurysms. With this technique, we can prevent coil migration into a parent artery during a procedure. Complications of intraprocedural coil migration have been reported in the literature. However, delayed coil migration is extremely rare. We present a case of delayed coil migration after balloon-assisted coil embolization and describe our management of this complication. CLINICAL PRESENTATION: A 59-year-old man presented with hypertension and a tension headache. Clinical evaluation incidentally discovered an unruptured broad-neck aneurysm at the left internal carotid bifurcation. Endovascular embolization of the aneurysm was performed with a balloon-assisted technique. The patient had a transient ischemic attack, and a skull radiograph showed coil migration 3 months after the procedure. We performed an operation to remove the coils and to clip the aneurysm with superficial temporal artery and middle cerebral artery bypass. The patient was discharged without neurological deficit. CONCLUSION: This is a rare case in which delayed coil migration into the parent artery occurred after balloon-assisted coil embolization, highlighting the importance of surgical management of delayed coil migration.

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Atypical Growing Pattern of Superficial Temporal Artery Pseudoaneurysm

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000003694 ◽

2017 ◽

Vol 28 (5) ◽

pp. e455-e458

Author(s):

Jeonghyun Ha ◽

Yong Hyun Kim ◽

Bo La Yun ◽

Kyu Sang Lee ◽

Chang-sik Pak ◽

...

Keyword(s):

Superficial Temporal Artery ◽

Temporal Artery ◽

Artery Pseudoaneurysm

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Surgical feed ligation performed in 22 year old female with scalp arteriovenous malformation

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20192608 ◽

2019 ◽

Vol 7 (7) ◽

pp. 2829

Author(s):

Nyoman Gde Trizka Santhiadi ◽

I. Nyoman Semadi

Keyword(s):

Arteriovenous Malformation ◽

Superficial Temporal Artery ◽

Vascular Anatomy ◽

Major Complication ◽

Surgical Excision ◽

Temporal Artery ◽

Endovascular Embolization ◽

Pulsatile Mass ◽

History Of ◽

Feeding Vessel

Scalp arteriovenous malformation (AVM) are rare conditions that usually need surgical treatment. Its management is difficult because of its high shunt flow, complex vascular anatomy, and possible cosmetic complication. The etiology of scalp AVM may be spontaneous or traumatic. This vascular lesion present as scalp lump or a mass, grotesque, pulsatile mass with a propensity to massive haemorrhage. Various treatment option that have been adopted to treat these lesions include surgical excision, ligation of feeding vessel, trans arterial and transvenous embolization, injection of sclerosant into the nidus and electro thrombosis. A 22-years-old-female referred to cardiothoracic division with a 10 years history of a large fronto-parietal pulsatile reddish soft mass, progressively increasing in size, measuring about 15x6x2 cm, ulcerated area; without any symptoms and history of trauma. Three-dimensional CT angiography demonstrated a mass that was completely within the scalp and prominent vascular that was completely within the scalp and was not associated with bone or periosteum. The feeding arteries were originated from angular artery, supratrochlear artery, left and right superficial temporal artery. Surgical excision and ligation of feeding vessel was performed without complication. With pre-operative appropriate surgical planning, scalp AVM can be excised safely without any major complication. Though some cases may be treated with percutaneous or endovascular embolization, surgery remains the treatment of choice. In the event of scalp ulceration and haemorrhage, total excision is the only option.

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Successful endovascular treatment of extracranial arteriovenous malformation of a head: a case report

Sechenov Medical Journal ◽

10.47093/22187332.2019.4.40-48 ◽

2019 ◽

Vol 10 (4) ◽

pp. 40-48

Author(s):

A. A. Sufianov ◽

S. M. Karasev ◽

R. R. Khafizov ◽

R. R. Rustamov ◽

R. A. Sufianov ◽

...

Keyword(s):

Case Report ◽

Superficial Temporal Artery ◽

Temporal Artery ◽

Vascular Supply ◽

Endovascular Embolization ◽

Maximum Effect ◽

Facial Soft Tissue ◽

Soft Tissue Necrosis ◽

Endovascular Methods ◽

The Right

Introduction. Arteriovenous malformations (AVM) of the head represent the rare lesions that have a congenital, traumatic or post-infectious nature. In the last decade, endovascular methods have become the most prevalent in the treatment of AVM. Staged embolization is performed to achieve maximum eﬀect and minimize the complications.Case report. A 30-year-old female patient is presented with complaints of enlarged vessels in the frontal and parietal regions. CT-angiography scan and cerebral angiography showed extracranial AVM of the fronto-parietal regions with aﬀerent vascular supply from the right and left superﬁcial temporal and ophtalmic arteries with signiﬁcant expansion of the aﬀerent arteries and the presence of varix dilatation of the draining veins. Two-stage endovascular embolization of AVM was performed. The ﬁrst stage was embolization of the aﬀerent vessels from the left superﬁcial temporal artery system with exclusion of 60–65% AVM volume. Three months later, the second stage was performed with embolization of the afferent vessels from the right superﬁcial temporal artery system and the exclusion of 75–80% of the residual volume of AVM. The non-adhesive composition SQUIDR12 (Emboﬂu, Switzerland) and glue composition PHILR25% (Microvention, USA) were used. A good aesthetic eﬀect was achieved. Postoperative complications were not observed. There was no recurrence during the observation within a year.Summary. The staging and the use of various liquid embolization agents in the treatment of AVM of the head allow to achieve a good aesthetic outcome and prevent complications associated with facial soft tissue necrosis.

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