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Reconstructive stent-buttressed coil embolization of a traumatic pseudoaneurysm of the supraclinoid internal carotid artery

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Abstract

It is critical that traumatic intracranial pseudoaneurysms should be removed completely from the parent artery because there is a possibility of significant morbidity and mortality from the high risk of rebleeding from any remnants of the pseudoaneurysm. However, the deconstruction of the parent artery has the risk of ischemic damage to the distal to the trapped artery. We describe a case of a successful reconstructive stent-buttressed coil embolization in a patient with a traumatic pseudoaneurysm of the intracranial internal carotid artery. A 30-year-old man with a stuporous mentality was admitted to our institution after a traffic accident. The initial computed tomography scan showed a diffuse subarachnoid hemorrhage and a pseudoaneurysm of the left supraclinoid internal carotid artery. A reconstructive endovascular treatment using stent-assisted coil embolization with a stent-within-a-stent technique was conducted in order to save carotid blood flow. The pseudoaneurysm was completely obliterated and the patient recovered without any neurological deficit. We suggest that multiple stent placements with coiling may be considered as a treatment option for intracranial traumatic pseudoaneurysms as a reconstructive treatment.

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References

  1. Bell RS, Vo AH, Roberts R, Wanebo J, Armonda RA (2010) Wartime traumatic aneurysms: acute presentation, diagnosis, and multimodal treatment of 64 craniocervical artery injuries. Neurosurgery 66:66–79

    Article  PubMed  Google Scholar 

  2. Benndorf G, Herbon U, Sollmann WP, Campi A (2001) Treatment of a ruptured dissecting vertebral artery aneurysm with double stent placement: case report. AJNR Am J Neuroradiol 22:1844–1848

    PubMed  CAS  Google Scholar 

  3. Cohen JE, Gomori JM, Segal R, Spivak A, Margolin E, Sviri G, Rajz G, Fraifeld S, Spektor S (2008) Results of endovascular treatment of traumatic intracranial aneurysms. Neurosurgery 63:476–485

    Article  PubMed  Google Scholar 

  4. Fiorella D, Albuquerque FC, Deshmukh VR, Woo HH, Rasmussen PA, Masaryk TJ, McDougall CG (2006) Endovascular reconstruction with the Neuroform stent as monotherapy for the treatment of uncoilable intradural pseudoaneurysmms. Neurosurgery 59:291–300

    Article  PubMed  Google Scholar 

  5. Fiorella D, Woo HH, Albuquerque FC, Nelson PK (2008) Definitive reconstruction of circumferential, fusiform intracranial aneurysms with the pipeline embolization device. Neurosurgery 62:1115–1120

    Article  PubMed  Google Scholar 

  6. Geremia G, Brack T, Brennecke L, Haklin M, Falter R (2000) Occlusion of experimentally created fusiform aneurysms with porous metallic stents. AJNR Am J Neuroradiol 21:739–745

    PubMed  CAS  Google Scholar 

  7. Holmes B, Harbaugh RE (1993) Traumatic intracranial aneurysms: a contemporary review. J Trauma 35:855–890

    Article  PubMed  CAS  Google Scholar 

  8. Hong B, Patel NV, Gounis MJ, DeLeo MJ III, Linfante I, Wojak JC, Wakhloo AK (2009) Semi-jailing technique for coil embolization of complex, wide-necked intracranial aneurysms. Neurosurgery 65:1131–1139

    Article  PubMed  Google Scholar 

  9. Kim BM, Chung EC, Park SI, Choi CS, Won YS (2007) Treatment of blood blister-like aneurysm of the internal carotid artery with stent-assisted coil embolization followed by stent-within-a-stent technique. Case report. J Neurosurg 107:1211–1213

    Article  PubMed  Google Scholar 

  10. Larson PS, Reisner A, Morassutti DJ, Abdulhadi B, Harpring JE (2000) Traumatic intracranial aneurysms. Neurosurg Focus 8:e4

    Article  PubMed  CAS  Google Scholar 

  11. Li MH, Li YD, Gao BL, Fang C, Luo QY, Cheng YS, Xie ZY, Wang YL, Zhao JG, Li Y, Wang W, Zhang BL, Li M (2007) A new covered stent designed for intracranial vasculature: application in the management of pseudoaneurysms of the cranial internal carotid artery. AJNR Am J Neuroradiol 28:1579–1585

    Article  PubMed  Google Scholar 

  12. Luo CB, Teng MM, Chang FC, Limg JF, Chang CY (2004) Endovascular management of the traumatic cerebral aneurysms associated with traumatic carotid cavernous fistulas. AJNR Am J Neuroradiol 25:501–505

    PubMed  Google Scholar 

  13. Saatci I, Cekirge HS, Ozturk MH, Arat A, Ergungor F, Sekerci Z, Senveli E, Er U, Turkoglu S, Ozcan OE, Ozgen T (2004) Treatment of internal carotid artery aneurysms with a covered stent: experience in 24 patients with mid-term follow-up results. AJNR Am J Neuroradiol 25:1742–1749

    PubMed  Google Scholar 

  14. Sim SY, Shin YS, Yoon SH (2008) Endovascular internal trapping of traumatic pericallosal pseudoaneurysmm with hydrogel-coated self-expandable coil in a child: a case report. Surg Neurol 69:418–422

    Article  PubMed  Google Scholar 

  15. Suh SH, Kim BM, Park SI, Kim DI, Shin YS, Kim EJ, Chung EC, Koh JS, Shin HC, Choi CS, Won YS (2009) Stent-assisted coil embolization followed by a stent-within-a-stent technique for ruptured dissecting aneurysms of the intracranial vertebrobasilar artery. J Neurosurg 111:48–52

    Article  PubMed  Google Scholar 

  16. Tan HQ, Li MH, Zhang PL, Li YD, Wang JB, Zhu YQ, Wang W (2011) Reconstructive endovascular treatment of intracranial aneurysms with the Willis covered stent: medium-term clinical and angiographic follow-up. J Neurosurg 114:1014–1020

    Article  PubMed  Google Scholar 

  17. Uzan M, Cantasdermir M, Seckin MS, Hanci M, Kocer N, Sarioglu AC, Islak C (1998) Traumatic intracranial carotid tree aneurysms. Neurosurgery 43:1314–1320

    PubMed  CAS  Google Scholar 

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Correspondence to Joonho Chung.

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Lim, Y.C., Kang, J.K. & Chung, J. Reconstructive stent-buttressed coil embolization of a traumatic pseudoaneurysm of the supraclinoid internal carotid artery. Acta Neurochir 154, 477–480 (2012). https://doi.org/10.1007/s00701-011-1251-7

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  • DOI: https://doi.org/10.1007/s00701-011-1251-7

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