Clinical and Angiographic Outcomes of Covered Stent for Reconstruction of Cavernous Internal Carotid Artery Traumatic Pseudoaneurysms: A Single-Center Case Series
Keywords:
Pseudoaneurysm, traumatic aneurysm, covered stent, case seriesAbstract
Background: Pseudoaneurysms (PSAs) of the internal carotid artery (ICA) are an uncommon condition where treatment consensus is lacking despite substantial development in both surgical and endovascular treatment. The covered stent has been reported in the treatment of these conditions, however, data are limited. Here we report our experience in utilizing the covered stent for traumatic PSAs with its outcome.
Method: We retrospectively reviewed patients from 2014 to 2021 with traumatic PSAs of the cavernous segment of the internal carotid artery who were treated by endovascular procedures using the covered stent. The treatment’s safety and efficacy were evaluated by neurological symptoms and improvement, angiographic obliteration, and complications.
Result: Of 6 patients, five had a history of head trauma and 1 case had an iatrogenic injury with 31.1 mean age (range, 16 to 56 years). All had PSAs at a cavernous segment of the ICA. Four patients (66.7%) presented with massive epistaxis. All cases had immediate aneurysm obliteration in a single session and hemorrhagic complication was noted in 1 case (16.7%). There are no clinical or angiographic signs of aneurysm recurrence at a mean follow-up of 29.6 months.
Conclusion: Endovascular treatment with covered stent graft placement for traumatic PSAs of cavernous internal carotid artery delivers favorable clinical and angiographic outcomes with a low rate of complication. Nevertheless, the covered stent should be used with caution especially in cases with multiple trauma to avoid hemorrhagic complications.
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