Carotid Artery Pseudoaneurysm after Endovascular Stent Placement: Diagnosis and Follow-up Duplex Ultrasonography

2005 ◽  
Vol 29 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Wei Zhou ◽  
Ruth L. Bush ◽  
Peter H. Lin ◽  
Megan D. Hodge ◽  
Deborah D. Felkai ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Stent Graft ◽  
Stent Placement ◽  
Duplex Ultrasound ◽  
Carotid Bifurcation ◽  
Carotid Stenting ◽  
Duplex Scan ◽  
Artery Pseudoaneurysm ◽  
Endovascular Stent Placement

Purpose Carotid artery pseudoaneurysm development after endarterectomy, albeit rare, has been attributed to patch deterioration. We present an unusual case of pseudoaneurysm development 1 year after stent placement for recurrent carotid artery stenosis. Case Report A 64-year-old man had transient hemiparesis develop 1 week after carotid artery endarterectomy (CEA) with patch angioplasty for monocular transient ischemic attack. Carotid angiography reviewed an intimal flap at the distal endarterectomy site, which was successfully treated with carotid stent placement. During a duplex scan 1 year later, he was found to have a symptomatic 2.5-cm pseudoaneurysm at the level of stented carotid bifurcation. This was successfully treated with a combined open and endovascular approach, which consisted of stent-graft placement by means of an open carotid exposure. Completion angiogram showed successful stent-graft exclusion of the pseudoaneurysm. A follow-up duplex scan 6 months later demonstrated diminution of pseudoaneurysm size without endoleak. Conclusion This report highlights the importance of duplex ultrasound surveillance in patients with CEA or carotid stenting, because it can accurately detect recurrent stenosis or carotid pseudoaneurysm. Moreover, a combined open and endovascular therapy using stent graft successfully treated the carotid pseudoaneurysm in our patient.

scholarly journals Cervical to Petrous Carotid Artery High-Flow Bypass for Carotid Artery Pseudoaneurysm Through Zygomatic Approach: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Rami O Almefty ◽  
Ossama Al-Mefty
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Treatment Options ◽  
Penetrating Trauma ◽  
Mass Effect ◽  
Carotid Bifurcation ◽  
Carotid Stenting ◽  
Balloon Occlusion ◽  
High Flow ◽  
Artery Pseudoaneurysm

Abstract Pseudoaneurysms of the cervical internal carotid artery may generate grave risk from catastrophic rupture, thromboembolic stroke, or mass effect. They have many causes, including malignancy, infection, and iatrogenic and most commonly blunt or penetrating trauma.1 These aneurysms require treatment to eliminate their risk. Treatment options include trapping, with or without revascularization, or endovascular stenting. Trapping without revascularization requires evaluation of the cerebral collateral under a physiological challenge, which is usually done with a balloon occlusion test, which is not applicable in this lesion.2 Occluding the carotid without revascularization carries the risk of delayed ischemia and aneurysm formation.3,4 Carotid stenting has been applied in the treatment of these lesions5,6; however, the extent of the lesion in our patient from the carotid bifurcation to the petrous carotid makes endovascular treatment challenging. We present a patient with a delayed post-traumatic pseudoaneurysm of the carotid artery that extended from the bifurcation to the petrous carotid who was treated with trapping and high-flow saphenous vein bypass from the proximal cervical internal carotid to the petrous carotid. Adequate exposure of the petrous carotid to perform anastomosis requires a thorough knowledge of the anatomy and surgical nuances, which we demonstrate here through a zygomatic approach.7 The patient consented to the procedure and publication of imaging. Image at 2:28 from Al-Mefty O, Operative Atlas of Meningiomas, © LWW, 1997, with permission.

scholarly journals Three-Stent Placement for Treatment of Carotid Artery Pseudoaneurysm

2006 ◽  
Vol 12 (4) ◽  
pp. 339-343 ◽  
Author(s):  
P. Amistà ◽  
D. Barbisan ◽  
M. Beghetto ◽  
N. Cavasin ◽  
P. Zucchetta ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Stent Placement ◽  
Left Carotid Artery ◽  
Artery Pseudoaneurysm ◽  
Bilateral Carotid ◽  
History Of ◽  
Aneurysmal Neck

Pseudoaneurysm treatment with overlapping stents may be a useful technique to reduce flow and enhance thrombosis in the aneurysmal sac. We treated a pseudoaneurysm of the left carotid artery in a patient with a history of bilateral carotid thromboendarterectomy by placing three stents and overlapping them at the level of the aneurysmal neck. Nine month follow-up revealed almost complete pseudoaneurysm exclusion and patency of the carotid artery.

Endovascular repair of subclavian artery aneurysms: results from a single-center experience

Perfusion ◽  
2017 ◽  
Vol 32 (8) ◽  
pp. 670-674 ◽  
Author(s):  
XiXiang Gao ◽  
LiQiang Li ◽  
YongQuan Gu ◽  
LianRui Guo ◽  
ShiJun Cui ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Treatment Outcomes ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Endovascular Repair ◽  
Stent Placement ◽  
Imaging Findings ◽  
Endovascular Stent ◽  
Endovascular Stent Placement

Objective: To present our experience of the endovascular treatment of subclavian artery aneurysms (SAAs) and analyze the clinical manifestations, imaging findings and treatment outcomes. Methods: In this retrospective study, nine patients with SAAs underwent endovascular stent placement in our center between July 2011 and June 2016. Clinical features, imaging findings, treatment outcomes and follow-up results of these SAA patients were retrospectively analyzed. Results: Nine patients were diagnosed with SAAs by computer tomography angiography (CTA). Five patients underwent percutaneous endovascular stent placement in the subclavian artery. Three patients underwent endovascular repair of the SAAs with coil embolization and stent graft. One patient underwent stent graft implantation by the simultaneous kissing stent technique. Five patients had their symptoms relieved and thrombosis occurred in one case. The mean follow-up period was 17 months, ranging from 8 to 40 months. Conclusion: For patients with SAAs, endovascular treatment is a feasible choice, with a high success rate, few complications and good clinical outcomes.

scholarly journals Endovascular Treatment of Extracranial Internal Carotid Pseudoaneurysm: Description of Three Cases

2016 ◽  
Vol 02 (02) ◽  
pp. e15-e18 ◽  
Author(s):  
Andrea Giorgianni ◽  
Carlo Pellegrino ◽  
Camilla Micieli ◽  
Anna Mercuri ◽  
Renzo Minotto ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Surgical Approach ◽  
Stent Placement ◽  
Internal Carotid ◽  
Carotid Dissection ◽  
Endovascular Stent ◽  
Artery Pseudoaneurysm ◽  
Endovascular Stent Placement

The aim of this study is to explore the possibility of endovascular treatment of internal carotid artery pseudoaneurysm (PSA). These lesions are difficult to treat with a surgical approach, especially if they are located extracranially and close to the skull base. Endovascular stent placement in symptomatic and unstable extracranial internal carotid PSA was found to be safe and effective. Depending on hemodynamic aspects, complete local exclusion of aneurysmal formation is achieved in few months. We present three patients with carotid dissection and PSA formation that have been successfully treated by stent placement.

A Comparison of Balloon-Mounted and Self-Expanding Stents in the Carotid Arteries: Immediate and Long-Term Results of More Than 500 Patients

2003 ◽  
Vol 10 (2) ◽  
pp. 171-181 ◽  
Author(s):  
Michael Henry Wholey ◽  
Mark Henry Wholey ◽  
Walter A. Tan ◽  
Gustave Eles ◽  
Chester Jarmolowski ◽  
...  
Keyword(s):  
Carotid Arteries ◽  
Duplex Ultrasound ◽  
Carotid Stenting ◽  
Neurological Complications ◽  
Long Term Results ◽  
Duplex Scan ◽  
Intention To Treat ◽  
Vessel Patency

Purpose: To compare the rates of neurological complications and restenosis for balloon-mounted (BM) versus self-expanding (SE) stents deployed in the extracranial carotid arteries. Methods: Among 513 patients (312 men; mean age 71.3 years, range 27–91) who underwent carotid artery stent placement, 496 received 520 stents. The patients were followed with periodic duplex ultrasound examinations; angiography was performed whenever the duplex scan identified a >50% stenosis or symptoms warranted investigation. Periproce-dural data on complications were analyzed on an intention-to-treat basis, while intermediate-term neurological complications were compared in stented patients. Results: In the periprocedural period, there were 19 (3.7%) transient ischemic attacks, 10 (1.9%) minor strokes, 6 (1.2%) major strokes, and 8 (1.6%) deaths among the 513 patients. Five (1.0%) of the deaths were related to neurological complications (3.9% all stroke/neurological death rate). Among the 496 patients receiving 247 (48%) BM stents and 273 (52%) SE stents in 518 arteries, the all stroke/neurological death rates were 3.6% and 4.0%, respectively (p>0.05). During a mean follow-up of 20.6 months (range to 5.6 years), the 3-year freedom from all fatal and ipsilateral nonfatal strokes excluding the 30-day periprocedural period was 95.0% for BM stents and 95.2% for SE devices. Vessel patency (>50%) at 3 years was 92.0% in the population: 96.3% for BM stents and 83.7% for SE stents (p=0.0422). Conclusions: The rate of neurological complications following carotid stenting has been relatively low overall, and no differences were found relative to the type of stent deployed. Vessel patency was excellent at 3 years, with slightly better patency in BM stents, but because of their vulnerability to compression, they will not replace SE stents.

A carotid bifurcation pseudoaneurysm treated endovascularly in a patient with irradiated neck

VASA ◽  
2019 ◽  
Vol 48 (2) ◽  
pp. 193-195
Author(s):  
Christiana Anastasiadou ◽  
Chrisostomos Maltezos ◽  
George Galyfos ◽  
Sotirios Giannakakis ◽  
Nikos Zannes ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Endovascular Treatment ◽  
Carotid Bifurcation ◽  
Rare Entity ◽  
Artery Pseudoaneurysm

Abstract. A carotid artery pseudoaneurysm in an irradiated neck is a rare entity with possible devastating results and management should be multidisciplinary. We present a successful endovascular treatment of a late carotid artery pseudoaneurysm following patch endarterectomy and cervical radiotherapy.

scholarly journals An Ultrasound Model to Predict the Short-Term Effects of Endovascular Stent Placement in the Treatment of Carotid Artery Stenosis

2021 ◽  
Vol 7 ◽  
Author(s):  
Sheng-Jiang Chen ◽  
Rui-Rui Liu ◽  
Yi-Ran Shang ◽  
Yu-Juan Xie ◽  
Xiao-Han Guo ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Stent Placement ◽  
Carotid Artery Stenosis ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Artery Stenosis ◽  
Endovascular Stent ◽  
Improvement Rate ◽  
Preoperative Ultrasound ◽  
Endovascular Stent Placement

Purpose: The present study aimed to explore the predictive ability of an ultrasound linear regression equation in patients undergoing endovascular stent placement (ESP) to treat carotid artery stenosis-induced ischemic stroke.Methods: Pearson's correlation coefficient of actual improvement rate (IR) and 10 preoperative ultrasound indices in the carotid arteries of 64 patients who underwent ESP were retrospectively analyzed. A predictive ultrasound model for the fitted IR after ESP was established.Results: Of the 10 preoperative ultrasound indices, peak systolic velocity (PSV) at stenosis was strongly correlated with postoperative actual IR (r = 0.622; P < 0.01). The unstable plaque index (UPI; r = 0.447), peak eccentricity ratio (r = 0.431), and plaque stiffness index (β; r = 0.512) moderately correlated with actual IR (P < 0.01). Furthermore, the resistance index (r = 0.325) and the dilation coefficient (r = 0.311) weakly correlated with actual IR (P < 0.05). There was no significant correlation between actual IR and the number of unstable plaques, area narrowing, pulsatility index, and compliance coefficient. In combination, morphological, hemodynamic, and physiological ultrasound indices can predict 62.39% of neurological deficits after ESP: fitted IR = 0.9816 – 0.1293β + 0.0504UPI – 0.1137PSV.Conclusion: Certain carotid ultrasound indices correlate with ESP outcomes. The multi-index predictive model can be used to evaluate the effects of ESP before surgery.

Clinical case of a patient with occlusive thrombosis of the right common carotid artery

2021 ◽  
Vol 27 (1) ◽  
pp. 79-86
Author(s):  
Anna S. Zotova ◽  
Tatyana V. Davydova ◽  
Anna M. Snigireva
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Asymptomatic Patient ◽  
Duplex Ultrasound ◽  
Carotid Bifurcation ◽  
Ultrasound Scanning ◽  
Severe Atherosclerosis ◽  
The Common ◽  
The Right ◽  
Color Duplex Ultrasound

The paper presents a case of a patient with floating thrombosis in the right common carotid artery and occlusion of the carotid bifurcation of the right common carotid artery against the background of severe atherosclerosis of the common carotid artery with 70% stenosis. Thrombosis was identified using color duplex ultrasound scanning in an asymptomatic patient. During hospitalization, thrombosis was complicated by a cerebral infarction of the right middle cerebral artery, apparently of embolic origin.

scholarly journals Stent graft exclusion of a mycotic profunda femoris artery pseudoaneurysm with 2-year follow-up

2019 ◽  
Vol 12 (6) ◽  
pp. e229087
Author(s):  
Ahmed Aboubakr-Esedik Bakr ◽  
James Harding ◽  
Asif Mahmood ◽  
Devaraj Srinivasamurthy
Keyword(s):  
Stent Graft ◽  
Graft Infection ◽  
Covered Stent ◽  
Long Term Results ◽  
Bacterial Invasion ◽  
Artery Pseudoaneurysm ◽  
Profunda Femoris Artery ◽  
Arterial Aneurysms ◽  
Profunda Femoris

Mycotic pseudoaneurysms develop at sites of intimal disruption where bacterial invasion occurs. The conventional treatment involves arterial ligation, excision and debridement, followed by a bypass procedure at a later point. Recently, covered stent grafts have been used to treat mycotic arterial aneurysms either as temporary or definitive procedures. However, this is associated with a risk of stent graft infection, recurrence and rupture. There is a paucity of long-term results on the durability of such endovascular stent graft procedures in mycotic arterial pseudoaneurysms. We describe a successful endovascular covered stent repair of a mycotic profunda femoris artery pseudoaneurysm and follow-up of this repair at 2 years.

Sign in / Sign up

Export Citation Format

Share Document