Endoluminal stent placement and coil embolization for the management of carotid artery pseudoaneurysms

R. L. Bush, P. H. Lin, T. F. Dodson, J. E. Dion, Alan B. Lumsden

Research output: Contribution to journalArticle

105 Scopus citations

Abstract

Purpose: To present a series of carotid artery pseudoaneurysms treated successfully using an endovascular approach. Methods: From April 1995 to November 1999, 5 patients with neurological symptoms not explained by computed tomography of the head were identified by carotid angiography as having internal carotid artery (ICA) pseudoaneurysms. Three patients had sustained blunt trauma, and 2 had previous elective carotid endarterectomies for atherosclerotic disease. The time between injury and treatment ranged from 3 days to 10 years. The patients were treated with endovascular stent placement for exclusion of the pseudoaneurysm, followed by filling of the cavity with multiple detachable coils. Patients were maintained on oral antiplatelet agents or anticoagulant therapy after the procedure. Results: Primary technical success was 100%. No patient suffered permanent neurological sequelae. Postprocedure angiography demonstrated a patent ICA in all cases, with complete obliteration of the pseudoaneurysm. At a mean 8.4-month follow-up (range 2-21), all patients remained symptom free; angiograms in 3 patients at a mean 11.7 months demonstrated continued ICA patency. One patient had a 60% focal narrowing of the distal common carotid artery, which was treated successfully with balloon dilation and stenting. Conclusions: Endovascular treatment of carotid artery pseudoaneurysms is a useful alternative to standard surgical repair. This modality avoids the necessity for surgical exposure at the skull base with its inherent morbidity.

Original languageEnglish (US)
Pages (from-to)53-61
Number of pages9
JournalJournal of Endovascular Therapy
Volume8
Issue number1
DOIs
StatePublished - Feb 19 2001

Keywords

  • Carotid trauma
  • Endovascular repair
  • Neurological symptoms
  • Smart stent
  • Wallstent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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