Covered Stent-graft Repair of the Brachiocephalic Arteries: Technical Note

Neurosurgery ◽  
2002 ◽  
Vol 51 (1) ◽  
pp. 247-253 ◽  
Author(s):  
Arun Paul Amar ◽  
George P. Teitelbaum ◽  
Steven L. Giannotta ◽  
Donald W. Larsen
Keyword(s):  
Carotid Artery ◽  
Stent Graft ◽  
Neurological Complications ◽  
Covered Stent ◽  
Technical Note ◽  
Parent Vessel ◽  
Vessel Patency ◽  
Stent Graft Repair ◽  
Antegrade Flow ◽  
Covered Stent Graft

Abstract OBJECTIVE The use of a covered stent-graft to repair disruptions of the cervical carotid and vertebral arteries is described. This device maintains vessel patency while effectively excluding pseudoaneurysms, arteriovenous fistulae, and other breaches in the integrity of the arterial wall. METHODS Patient 1 bled from a large rent in the proximal common carotid artery as a result of tumor invasion. Patient 2 developed a vertebral arteriovenous fistula after a stab injury to the neck. Patient 3 developed cerebral infarction and an enlarging pseudoaneurysm of the internal carotid artery, also after a stab wound to the neck. RESULTS All three patients were treated with the Wallgraft endoprosthesis (Boston Scientific, Watertown, MA). In each case, the vessel wall defect was repaired while antegrade flow through the artery was preserved or restored. No neurological complications occurred as a result of stent-graft deployment. CONCLUSION Covered stent-grafts offer an alternative to endovascular occlusion of the parent vessel, thereby expanding the therapeutic options for patients with extracranial cerebrovascular disease. These three cases highlight the usefulness and versatility of these devices for endoluminal reconstruction of the brachiocephalic vasculature.

scholarly journals Telescoping Dual Covered Stent Graft Construct for Endovascular Treatment of a Giant Extracranial Carotid Artery Pseudoaneurysm

2016 ◽  
Vol 07 (S 01) ◽  
pp. S103-S105
Author(s):  
Dale Ding ◽  
Robert M. Starke ◽  
Maurice Moriarty ◽  
Stefan Brew
Keyword(s):  
Carotid Artery ◽  
Endovascular Treatment ◽  
Stent Graft ◽  
Covered Stent ◽  
Parent Artery ◽  
Artery Pseudoaneurysm ◽  
Extracranial Carotid Artery ◽  
Luminal Narrowing ◽  
Proximal Internal Carotid Artery ◽  
Covered Stent Graft

ABSTRACTLarge pseudoaneurysms which compress the parent vessel are challenging lesions to successfully treat with endovascular therapy. We describe the endovascular treatment of a giant extracranial carotid artery (ECCA) pseudoaneurysm resulting in substantial mass effect on the common carotid artery (CCA) bifurcation using a telescoping dual covered stent graft construct. A 56-year-old male was diagnosed with an 8.5 cm × 13 cm pseudoaneurysm arising from the left CCA bifurcation, which was causing luminal narrowing of the CCA and proximal internal carotid artery (ICA). The patient underwent endovascular intervention, during which a balloon-expandable covered stent was deployed within a heparin-bonded covered stent, such that the overall construct spanned from the CCA to the lower cervical ICA. The employment of a telescoping dual covered stent technique can successfully treat appropriately selected patients with large or giant ECCA pseudoaneurysms, with the concomitant goals of excluding the pseudoaneurysm and restoring the luminal caliber of the parent artery.

Endovascular treatment of extracranial carotid artery aneurysms using self-expandable covered stent grafts: A single center retrospective study

Vascular ◽  
2021 ◽  
pp. 170853812199012
Author(s):  
Peixian Gao ◽  
Jiaxin Qi ◽  
Mo Wang ◽  
Gang Li ◽  
Le Yang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Endovascular Treatment ◽  
Stent Graft ◽  
Common Carotid Artery ◽  
Covered Stent ◽  
Imaging Features ◽  
Stent Grafts ◽  
Extracranial Carotid Artery ◽  
Covered Stent Graft

Objectives This study was aimed to evaluate the safety and efficacy of endovascular treatment of extracranial carotid artery aneurysms (ECAAs) using self-expandable covered stent grafts. Methods All patients with ECAA at a single institution were reviewed from February 2014 to February 2020. Eight consecutive patients (three men, mean age 64.5 years) treated with endovascular repair with self-expandable covered stent graft were retrospectively reviewed. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. Access to ECAA was gained via a femoral approach or a direct puncture of common carotid artery after surgical exposure because of kinking of the aortic arch and common carotid artery. A self-expandable covered stent graft (Viabahn; W. L. Gore, Flagstaff, AZ) was deployed to exclude the aneurysm. Results Based on imaging features, there were five peudoaneurysms and three true aneurysms. The technical success rate was 100%. Cerebral protection devices were not used in all the patients during the procedures. Immediate absolute obliteration of the ECAA with no endoleak was documented in all the patients. Perioperative complications included one internal carotid-cavernous sinus fistula, one bleeding at the puncture site, and one stroke. The mean follow-up period was 35.5 months (range, 9–72 months). All the patients were alive, with an obligation rate of 100%. No transient ischemia attack, stroke, or reoccurrence of symptoms was identified during the follow-up period. Radiological examinations identified patency of the stent grafts and revealed no endoleaks, stent fracture, stent migration, or aneurysm rupture. Conclusions Endovascular treatment of ECAAs with self-expandable covered stent grafts appears to be a safe and feasible alternative for traditional open surgery, especially in the challenging anatomy and instable physical conditions. Although cerebrovascular accidents can occur as the result of hemodynamic changes during the perioperative period, the minimal alternative can yield satisfactory midterm follow-up clinical outcomes.

scholarly journals Treatment of an Acute Mycotic Aneurysm of the Common Carotid Artery with a Covered Stent-Graft

2012 ◽  
Vol 53 (1) ◽  
pp. 224 ◽  
Author(s):  
Suk Hoon Lee ◽  
Young Kwon Cho ◽  
Jong Moo Park ◽  
Curie Chung ◽  
Hyun Suk Kim ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Stent Graft ◽  
Common Carotid Artery ◽  
Mycotic Aneurysm ◽  
Covered Stent ◽  
The Common ◽  
Covered Stent Graft

scholarly journals A Case Report

2012 ◽  
Vol 18 (4) ◽  
pp. 386-390 ◽  
Author(s):  
R. Agid ◽  
M. Simons ◽  
L.K. Casaubon ◽  
K. Sniderman
Keyword(s):  
Carotid Artery ◽  
Stent Graft ◽  
Relevant Literature ◽  
Covered Stent ◽  
Puncture Site ◽  
Carotid Blowout Syndrome ◽  
Neck Tumors ◽  
Technical Details ◽  
The Common ◽  
Covered Stent Graft

We present a rare case of carotid tear caused by iatrogenic erroneous insertion of a dialysis sheath into the common carotid artery (CCA). This was treated by placement of a covered stent-graft in the CCA over the puncture site. This treatment achieved hemostasis while preserving the carotid artery with good outcome. The technical details are presented and the relevant literature regarding treatment of carotid blowout syndrome is discussed. This case suggests that placement of a covered stent-graft is a good option not only for the “usual” blowout syndrome due to head and neck tumors, but also for treatment of iatrogenic injury to the carotid artery.

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

2006 ◽  
Vol 29 (6) ◽  
pp. 958-968 ◽  
Author(s):  
Dimitrios Maras ◽  
Christos Lioupis ◽  
George Magoufis ◽  
Nikolaos Tsamopoulos ◽  
Konstantinos Moulakakis ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Graft ◽  
Internal Carotid ◽  
Covered Stent ◽  
Covered Stent Graft

Covered Stent-graft Exclusion of External Carotid Artery Pseudoaneurysms without Compromise of the Complex Free Flap

2010 ◽  
Vol 21 (3) ◽  
pp. 406-409 ◽  
Author(s):  
Vicko Gluncic ◽  
Amir H. Dorafshar ◽  
Nedra Joyner ◽  
Lawrence J. Gottlieb ◽  
Sameer A. Ansari
Keyword(s):  
Carotid Artery ◽  
Stent Graft ◽  
Free Flap ◽  
Covered Stent ◽  
External Carotid Artery ◽  
External Carotid ◽  
Covered Stent Graft

scholarly journals Endovascular treatment of iatrogenic penetrating trauma of the carotid artery: case report

2014 ◽  
Vol 13 (2) ◽  
pp. 155-158
Author(s):  
Eduardo Lichtenfels ◽  
Marco Aurelio Cardozo ◽  
Nilon Erling Jr. ◽  
Newton Roesch Aerts
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Stent Graft ◽  
Open Repair ◽  
Penetrating Trauma ◽  
Covered Stent ◽  
Puncture Site ◽  
Hemodialysis Catheter ◽  
The Common ◽  
Covered Stent Graft

Carotid trauma demands early diagnosis and treatment. Open repair may be technically challenging if the trauma is at the base of the neck. We present a case of iatrogenic penetrating carotid trauma caused by insertion of a hemodialysis catheter. Treatment was accomplished by placement of a covered stent-graft in the common carotid artery, covering the puncture site. This case suggests that placement of a covered stent-graft is a good option for treatment of iatrogenic injury to the carotid artery.

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