scholarly journals Recurrence of an internal carotid artery aneurysm after complete exclusion by a Willis covered stent

2019 ◽  
Vol 25 (6) ◽  
pp. 688-691
Author(s):  
Zhongbin Tian ◽  
Shiqing Mu ◽  
Wenqiang Li ◽  
Wei Zhu ◽  
Ying Zhang ◽  
...  
Keyword(s):  
Artery Aneurysm ◽  
Covered Stent ◽  
Aneurysm Rupture ◽  
Aneurysm Neck ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Long Term Follow Up ◽  
Complete Exclusion ◽  
Aneurysm Occlusion

Treatment of selective intracranial aneurysms treated with a Willis covered stent is safe and effective. We describe a previously unreported case of a large, irregular, carotid-ophthalmic aneurysm that was treated with a Willis covered stent. An immediate angiogram after the procedure showed complete occlusion of the aneurysm. However, a six-month follow-up angiogram demonstrated contrast media filling of the aneurysm neck. To the best of our knowledge, this is the first report of a recurrent aneurysm treated with a Willis covered stent because of a membrane partially isolated with the stent. This case suggests that an aneurysm that is treated with a Willis covered stent might recanalise, and the risk of aneurysm rupture persists when the membrane of the stent is isolated with the stent. Therefore, follow-up angiography is necessary, even if an immediate angiogram shows complete aneurysm occlusion. Long-term follow-up is required, and the final outcome of such a case is still unknown.

scholarly journals Cavernous carotid artery large aneurysm treated with a new flow diverter – Xcalibur aneurysm occlusion device (AOD)

2020 ◽  
Vol 26 (5) ◽  
pp. 586-592
Author(s):  
Richa Singh Chauhan ◽  
Nihar Vijay Kathrani ◽  
Karthik Kulanthaivelu ◽  
Chandrajit Prasad ◽  
Arun Kumar Gupta
Keyword(s):  
Carotid Artery ◽  
Artery Aneurysm ◽  
Mass Effect ◽  
Flow Diverter ◽  
Carotid Artery Aneurysm ◽  
Occlusion Device ◽  
Internal Carotid Artery Aneurysm ◽  
Complete Exclusion ◽  
Aneurysm Occlusion ◽  
Large Aneurysm

We report a case of an unruptured, symptomatic, large right cavernous internal carotid artery aneurysm successfully treated with a new balloon-expandable flow diverter – Xcalibur Aneurysm Occlusion Device (AOD). Follow up imaging performed at six months demonstrated complete exclusion of the aneurysm and regression in dimensions, resulting in resolution of mass effect and clinical improvement.

scholarly journals Multiple pipeline twists encountered during treatment of a symptomatic fusiform ICA aneurysm

2019 ◽  
Vol 12 (7) ◽  
pp. e230036 ◽  
Author(s):  
Robert W Young ◽  
Matthew T Bender ◽  
Geoffrey P Colby ◽  
Alexander L Coon
Keyword(s):  
Internal Carotid ◽  
Thrombus Formation ◽  
Artery Aneurysm ◽  
Long Term Outcomes ◽  
Parent Vessel ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Aneurysm Occlusion

Pipeline embolisation device (PED) ‘twisting’ is an intra-operative complication that manifests with the appearance of a ‘figure-8’ in perpendicular planes on digital subtraction angiography. A twisted PED causes narrowing and/or complete occlusion of the vessel lumen and poses significant risks for thrombus formation and downstream ischaemia. Here, we present a case in which three unique PED implants become twisted during pipeline embolisation of a large fusiform internal carotid artery aneurysm. The twists were remediated by balloon angioplasty and a combination of techniques that allowed the PED to rotate and restore its original axis. Six-month and twelve-month follow-up angiography demonstrated complete aneurysm occlusion with preservation of the parent vessel, proving that proper remediation of PED twisting can still result in successful long-term outcomes.

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.

scholarly journals Marked Hyperprolactinemia Caused by Carotid Aneurysm

1997 ◽  
Vol 24 (1) ◽  
pp. 64-66 ◽  
Author(s):  
Susan R. Kahn ◽  
Richard Leblanc ◽  
Abbas F. Sadiko ◽  
I. George Fantus
Keyword(s):  
Prolactin Level ◽  
Artery Aneurysm ◽  
Cranial Computed Tomography ◽  
Serum Prolactin ◽  
Left Internal Carotid Artery ◽  
Carotid Artery Aneurysm ◽  
Pituitary Dysfunction ◽  
Internal Carotid Artery Aneurysm ◽  
Aneurysm Repair

ABSTRACT:Background:Pituitary dysfunction caused by intracranial aneurysms is rare. We report a patient with the unique feature of hyperprolactinemia to a degree previously seen only with prolactinsecreting tumours.Method:Case report.Result:A 42-year-old woman had a galactorrhea, left-sided headache, reduced vision in the left eye and a left temporal hemianopsia. Serum prolactin was elevated (365 μg/L). Cranial computed tomography (CT) revealed a suprasellar mass, which carotid angiography showed to be a left internal carotid artery aneurysm. At craniotomy, this aneurysm and a smaller one of the ophthalmic artery were repaired, and the patient's vision returned to normal. The prolactin level fell to normal. Follow-up CT showed no evidence of pituitary adenoma or hypothalamic lesion.Conclusions:Carotid aneurysm can cause reversible pituitary dysfunction. A prolactin level >300 μg/L is not a reliable cut-off for distinguishing prolactin-secreting adenomas from other causes of elevated prolactin. A co-existing prolactinoma was felt to be ruled out by both a normal CT scan and normal prolactin levels following aneurysm repair. Patients with marked hyperprolactinemia should be considered for angiography or MRI to rule out carotid aneurysm, since the consequences of pituitary exploration in this setting are potentially grave.

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