Fenestration of a Supraclinoid Internal Carotid Artery Associated With Dual Aneurysms: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 69 (4) ◽  
pp. E1005-E1009 ◽  
Author(s):  
Tsuyoshi Ichikawa ◽  
Shigeru Miyachi ◽  
Takashi Izumi ◽  
Noriaki Matsubara ◽  
Takehiro Naito ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Coil Embolization ◽  
Internal Carotid ◽  
Neurological Deficits ◽  
Left Internal Carotid Artery ◽  
High Incidence ◽  
Endovascular Coil Embolization ◽  
Proximal Occlusion ◽  
Supraclinoid Internal Carotid Artery

Abstract BACKGROUND AND IMPORTANCE: We present a rare case of fenestration of the left supraclinoid intracranial internal carotid artery with 2 associated aneurysms arising proximally and distally from the fenestration that were successfully treated with endovascular coil embolization. This is the first report of these types of aneurysms treated with coiling alone. CLINICAL PRESENTATION: A 47-year-old woman underwent a diagnostic workup; magnetic resonance angiography incidentally revealed 2 tandem aneurysms at the supraclinoid and paraclinoid portion of the left internal carotid artery. Angiography revealed fenestration of the left supraclinoid internal carotid artery with 2 aneurysms both proximal and distal to the fenestration. The patient underwent endovascular coil embolization of the aneurysms simultaneously. The smaller trunk was intentionally occluded to achieve complete packing of the proximal aneurysm. Both aneurysms were totally occluded, and no neurological deficits developed in the patient. CONCLUSION: Based on previous reports, fenestration has the potential to form an aneurysm, and there seemed to be a relatively high incidence of rupture if accompanied by aneurysm. Coiling is one good option to treat aneurysms and should be considered when multiple aneurysms exist because all aneurysms can be treated simultaneously. Proximal occlusion of the smaller trunk is acceptable because of a retrograde flow from the distal end, even if one exists.

Endovascular coil embolization of the left internal carotid artery aneurysm. Case report.

2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Adam Lipowski ◽  
Sleiman Aboul-Hassan ◽  
Zbigniew Krasiński ◽  
Konrad Woronowicz
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Coil Embolization ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Left Internal Carotid Artery ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Endovascular Coil Embolization ◽  
Angio Ct

In the current case report we present a novel case of a successful coil embolization of the left internal carotid artery aneurysm. Patient presented with neck pain and a palpable pulsating tumor was admitted to the vascular surgery clinic where neck Angio-CT scan was performed. Angio-CT revealed left internal carotid artery aneurysm with a narrow neck. Patient was admitted to the department of vascular surgery where the patient was enrolled into endovascular coil embolization. After the procedure, control angiography showed complete embolization of the aneurysm. Three months following the procedure, doppler ultrasonography of the carotid arteries showed no demonstrable flow into the aneurysm. Six months following the procedure, angio-CT confirmed complete aneurysm thrombosis. Based on this case, endovascular coil embolization of the carotid artery aneurysms is safe and effective method of treatment. Keywords: tumor, aneurysm, coile.

scholarly journals The Efficacy of Endovascular Treatment of Ruptured Blood Blister-Like Aneurysms Using Stent-Assisted Coil Embolization

2012 ◽  
Vol 18 (4) ◽  
pp. 432-441 ◽  
Author(s):  
Y.K. Ihn ◽  
S.H. Kim ◽  
J.H. Sung ◽  
T-G. Kim
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Coil Embolization ◽  
Internal Carotid ◽  
Treatment Strategies ◽  
Additional Treatment ◽  
Stent Insertion ◽  
Supraclinoid Internal Carotid Artery

We report our experience with endovascular treatment and follow-up results of a ruptured blood blister-like aneurysm (BBA) in the supraclinoid internal carotid artery. We performed a retrospective review of ruptured blood blister-like aneurysm patients over a 30-month period. Seven patients (men/women, 2/5; mean age, 45.6 years) with ruptured BBAs were included from two different institutions. The angiographic findings, treatment strategies, and the clinical (modified Rankin Scale) and angiographic outcomes were retrospectively analyzed. All seven BBAs were located in the supraclinoid internal carotid artery. Four of them were ≥ 3 mm in largest diameter. Primary stent-assisted coiling was performed in six out of seven patients, and double stenting was done in one patient. In four patients, the coiling was augmented by overlapping stent insertion. Two patients experienced early re-hemorrhage, including one major fatal SAH. Complementary treatment was required in two patients, including coil embolization and covered-stent placement, respectively. Six of the seven BBAs showed complete or progressive occlusion at the time of late angiographic follow-up. The clinical midterm outcome was good (mRS scores, 0–1) in five patients. Stent-assisted coiling of a ruptured BBA is technically challenging but can be done with good midterm results. However, as early regrowth/re-rupture remains a problem, repeated, short-term angiographic follow-up is required so that additional treatment can be performed as needed.

scholarly journals A Case of Ruptured Blood Blister-like Aneurysm of internal Carotid Artery Treated with Wrap-clipping Followed by Endovascular Coil Embolization

2010 ◽  
Vol 38 (5) ◽  
pp. 358-362 ◽  
Author(s):  
Rei KONDO ◽  
Miiko ITO ◽  
Kenichiro MATSUDA ◽  
Shinjiro SAITO ◽  
Yasuaki KOKUBO ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Coil Embolization ◽  
Internal Carotid ◽  
Endovascular Coil Embolization

Retained Transcranial Knife Blade With Transection of the Internal Carotid Artery Treated by Staged Endovascular and Surgical Therapy: Technical Case Report

2015 ◽  
Vol 11 (2) ◽  
pp. 372-375 ◽  
Author(s):  
Lisa M Kodadek ◽  
W Robert Leeper ◽  
Justin M Caplan ◽  
Camilo Molina ◽  
Kent A Stevens ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Surgical Therapy ◽  
Coil Embolization ◽  
Foreign Bodies ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Knife Blade ◽  
Neurologically Intact

Abstract BACKGROUND AND IMPORTANCE We describe the use of proximal and distal endovascular coil embolization of the internal carotid artery followed by operative removal of a retained foreign object transecting the petrocavernous portion of the internal carotid artery. CLINICAL PRESENTATION A 20-year-old man sustained a stab wound to the left temporal skull and presented with a retained knife blade. He reported a headache at presentation, but remained neurologically intact with a Glasgow Coma Scale of 15. Computed tomography imaging and subsequent angiography confirmed complete transection of the petrocavernous segment of the left internal carotid artery with effective tamponade by the knife blade in situ and satisfactory collateral flow across the Circle of Willis. Coil embolization of the left internal carotid artery was performed. Retrograde embolization of the petrocavernous internal carotid segment distal to the injury was performed via vertebral and posterior communicating artery access. Antegrade embolization of the internal carotid artery proximal to the injury was completed and the patient was transferred to the operating room for craniectomy and foreign body extraction. Postoperative computed tomography angiography revealed no parenchymal hemorrhage, mass effect, or midline shift, and successful embolization of the internal carotid artery. At 6-week follow-up, the patient remained neurologically intact with no infectious or vascular complications. CONCLUSION Staged endovascular and surgical therapy provides complete assessment and effective control of damaged vessels when retained intracranial foreign bodies are present. Given the high risk of vascular injury with retained transcranial foreign bodies, this strategy should be considered a safe approach for these challenging cases.

Endovascular coil embolization for saccular-shaped blood blister-like aneurysms of the internal carotid artery

2010 ◽  
Vol 153 (2) ◽  
pp. 287-294 ◽  
Author(s):  
Noriaki Matsubara ◽  
Shigeru Miyachi ◽  
Nobuhiro Tsukamoto ◽  
Takashi Izumi ◽  
Takehiro Naito ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Coil Embolization ◽  
Internal Carotid ◽  
Endovascular Coil Embolization

Supraclinoid internal carotid artery fenestration with an associated aneurysm

1993 ◽  
Vol 79 (3) ◽  
pp. 438-441 ◽  
Author(s):  
Michael J. Banach ◽  
Eugene S. Flamm
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Content Type ◽  
The Third ◽  
The Right ◽  
Fine Print ◽  
Supraclinoid Internal Carotid Artery

✓ The case of an aneurysm occurring at the site of fenestration of the supraclinoid portion of the left internal carotid artery (ICA) is reported. A 37-year-old woman presenting with subarachnoid hemorrhage was found to have bilateral ICA aneurysms at the level of the posterior communicating arteries (PCoA's). The patient underwent right-sided craniotomy with uneventful clipping of the right PCoA aneurysm, and attempted clip placement on the contralateral left ICA aneurysm. The follow-up angiogram revealed a residual dome on the left ICA aneurysm, which was noted to originate at the proximal end of a fenestration of the left supraclinoid ICA. This represents the third reported case of fenestration of the intracranial ICA associated with an aneurysm. Intracranial artery fenestrations and their embryological origins are also reviewed.

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