Stent-assisted Coil Embolization to Treat Extracranial Carotid Artery Aneurysm 13 Years after Endarterectomy: A Case Report.
endovascular treatment
extracranial carotid artery aneurysm after carotid endarterectomy
stent-assisted coil embolization
Journal
NMC case report journal
ISSN: 2188-4226
Titre abrégé: NMC Case Rep J
Pays: Japan
ID NLM: 101692589
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
14
02
2019
accepted:
06
06
2019
entrez:
16
1
2020
pubmed:
16
1
2020
medline:
16
1
2020
Statut:
epublish
Résumé
Development of extracranial carotid artery aneurysm (ECCA) after carotid endarterectomy (CEA) is a rare complication, occurring in connection with <1% of all CEAs. The main causes are infection, suture failure, and degeneration of arterial wall or patch. The traditional treatment has been operative repair, which can present a significant technical challenge owing to reoperative neck inflammation and potential cranial nerve injuries. Here, we report a case of successful stent-assisted coil embolization for right noninfectious ECCA. A 63-year-old female was admitted to our hospital for a 3-cm pulsating mass in her right midneck. Doppler examination and digital subtraction angiography revealed a large (15 mm) ECCA at the right common carotid artery (CCA). Thirteen years earlier, eversion CEA with patch angioplasty and abbreviation of the internal carotid artery (ICA) had been performed for a symptomatic 80% diameter stenosis with transient ischemic attack at another hospital. As the patient refused blood transfusion for religious reasons, we treated her with stent-assisted coil embolization, which achieved nearly complete obliteration of the aneurysm while preserving the parent artery patency. Three months after initial treatment, ultrasound revealed complete occlusion of the ECCA, but also showed stent shortening. Hence, we performed an additional stent placement so as to overlap the previous stent by 2.5 cm. Six months after initial treatment, carotid duplex ultrasound confirmed a good outcome. This procedure is an excellent choice for high-risk patients, and a larger case series is needed to establish this technique as the treatment of choice for ECCAs.
Identifiants
pubmed: 31938678
doi: 10.2176/nmccrj.cr.2019-0030
pii: nmccrj-7-23
pmc: PMC6957776
doi:
Types de publication
Case Reports
Langues
eng
Pagination
23-27Informations de copyright
© 2020 The Japan Neurosurgical Society.
Déclaration de conflit d'intérêts
Conflicts of Interest Disclosure All authors have no conflicts of interest.
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