Unilateral congenital elongation of the cervical part of the internal carotid artery with kinking and looping: two case reports and review of the literature

Abstract BACKGROUND AND IMPORTANCE: As the use of flow-diverting stents (FDSs) for intracranial aneurysms expands, a small number of case reports have described the successful treatment of blister aneurysms of the internal carotid artery with flow diversion. Blister aneurysms are uncommon and fragile lesions that historically have high rates of morbidity and mortality despite multiple treatment strategies. We report a case of rebleeding after treatment of a ruptured blister aneurysm with deployment of a single FDS. CLINICAL PRESENTATION: A 29-year-old man presented with subarachnoid hemorrhage and a ruptured dorsal variant internal carotid artery aneurysm. Despite a technically successful treatment with a single FDS, a second catastrophic hemorrhage occurred during the course of his hospitalization. CONCLUSION: This case highlights the risk of hemorrhage during the period after deployment of a single FDS. Ruptured aneurysms, especially of the blister type, are at risk for rehemorrhage while the occlusion remains incomplete after flow diversion.

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Letter to the Editor Regarding “Delayed Pipeline Embolization of a Ruptured True Internal Carotid Artery Aneurysm Presenting with Epistaxis—Case Report and Review of the Literature”

World Neurosurgery ◽

10.1016/j.wneu.2019.03.299 ◽

2019 ◽

Vol 128 ◽

pp. 630

Author(s):

Lun-Xin Liu ◽

Xiao-Dong Xie

Keyword(s):

Case Report ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Artery Aneurysm ◽

Review Of The Literature ◽

Carotid Artery Aneurysm ◽

Letter To The Editor ◽

Internal Carotid Artery Aneurysm

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Application of flow diverters in the treatment of aneurysms in the internal carotid artery bifurcation region

The Neuroradiology Journal ◽

10.1177/1971400920924840 ◽

2020 ◽

Vol 33 (4) ◽

pp. 297-305

Author(s):

Mostafa Mahmoud ◽

Ahmed Farag ◽

Mostafa Farid ◽

Ahmed Elserwi ◽

Amr Abdelsamad ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Case Reports ◽

Therapeutic Option ◽

Case Series ◽

Flow Diversion ◽

Occlusion Rate ◽

Flow Diverters

Introduction The treatment of aneurysms in the internal carotid bifurcation region (ICABR), including aneurysms of the true internal carotid artery (ICA) terminus, those inclined on the proximal A1 or M1 segments or at the most distal pre-bifurcation (ICA) segment, is often challenging in microsurgical clipping and endovascular surgery. Few reports had discussed flow diversion as a therapeutic option for this group. Methods This was a retrospective study analysing flow diversion in treating ICABR aneurysms. Seven patients harbouring eight aneurysms in the ICABR were treated with flow diversion. Five aneurysms were inclined on the proximal A1 segment, and three were located at the most distal pre-bifurcation segment. Patients’ demographics, presentation, procedure technical description, angiographic and clinical follow-up were recorded. PubMed and Ovid MEDLINE were also reviewed for articles published in English, including case series or case reports, for ICABR aneurysms treated with flow diverters. Results All patients except one underwent angiographic follow-up. The Karman–Byrne occlusion scale was used to determine the occlusion rate. All six patients with documented angiographic follow-up had a class IV occlusion score. No permanent or transient neurological or non-neurological complications were encountered in this study. Conclusion Treating ICABR aneurysms using flow diversion is feasible, with a promising angiographic occlusion rate. Further studies are needed to analyse long-term clinical and angiographic results.

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Aneurysm of the Kinked Extracranial Internal Carotid Artery Case Report and Review of the Literature

Acta Chirurgica Belgica ◽

10.1080/00015458.2005.11679747 ◽

2005 ◽

Vol 105 (4) ◽

pp. 407-409 ◽

Cited By ~ 12

Author(s):

U. Alpagut ◽

M. Ugurlucan ◽

E. Kafali ◽

O. Ali Sayin ◽

T. Demir ◽

...

Keyword(s):

Case Report ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Review Of The Literature ◽

Extracranial Internal Carotid Artery

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An Operative Complication in a Patient with a True Posterior Communicating Artery Aneurysm: Case report and Review of the Literature

Neurosurgery ◽

10.1227/00006123-199010000-00028 ◽

1990 ◽

Vol 27 (4) ◽

pp. 650-653 ◽

Cited By ~ 14

Author(s):

Tadashi Kudo

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Artery Aneurysm ◽

Oculomotor Nerve ◽

Posterior Communicating Artery ◽

Review Of The Literature ◽

Operative Complications ◽

Posterior Communicating Artery Aneurysm ◽

Aneurysmal Neck

Abstract Intraoperative oculomotor nerve injury in a patient with a true posterior communicating artery aneurysm is reported in detail. A comparison of internal carotid artery aneurysms at the posterior communicating artery junction with true posterior communicating artery aneurysms deserves special attention, because the vascular relationships of the aneurysm are more complex. A clip along the internal carotid artery does not occlude blood flow to the aneurysm, and the aneurysmal neck and the distal posterior communicating artery are closer to the oculomotor nerve. This is the 27th reported case of a true posterior communicating artery aneurysm. The incidence of true posterior communicating artery aneurysms ranges from 0.1 to 2.8% of all aneurysm patients. Such aneurysms constitute 4.6 and 11% of so-called posterior communicating aneurysms in two series. Difficulty associated with a preoperative diagnosis has been documented in at least 4 cases. An awareness of this rare aneurysm is stressed in order to avoid operative complications.

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Internal Carotid Artery Pseudoaneurysms: Treatment with the Wallgraft Endoprosthesis

Journal of Endovascular Therapy ◽

10.1177/152660280301000204 ◽

2003 ◽

Vol 10 (2) ◽

pp. 182-189 ◽

Cited By ~ 28

Author(s):

Stephen M. Kubaska ◽

Roy K. Greenberg ◽

Daniel Clair ◽

Gregory Barber ◽

Sunita D. Srivastava ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Fibromuscular Dysplasia ◽

Internal Carotid ◽

Case Reports ◽

Duplex Ultrasound ◽

Ct Scanning ◽

Percutaneous Approach ◽

Spontaneous Dissection

Purpose: To report several cases illustrating the feasibility and mid-term efficacy of deploying a self-expanding stent-graft to treat traumatic ruptures, pseudoaneurysms, and a spontaneous dissection of the internal carotid artery (ICA). Case Reports: One patient suffered a stab wound and another developed a large pseudoaneurysm years after a gunshot to the neck. The third patient presented with a spontaneous rupture in the setting of fibromuscular dysplasia, and the final patient developed a pseudoaneurysm following carotid endarterectomy in an irradiated neck. All 4 patients were successfully treated with Wallgrafts deployed in the ICA using either an open carotid (first 3 cases) or percutaneous approach (fourth patient). There were no adverse neurological events. During a mean 16-month follow-up (range 6–24), duplex ultrasound and CT scanning found no evidence of restenosis, occlusion, or persistent perfusion of the pseudoaneurysm, which was noted to decrease in all cases. Conclusions: The thin-walled fabric of the Wallgraft appears capable of completely excluding the pseudoaneurysm, resulting in decreased aneurysm size overtime.

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