1/28. Bilateral traumatic caroticocavernous fistulae: total resolution following unilateral occlusion.balloon occlusion is the accepted treatment for direct posttraumatic caroticocavernous fistula. We present a case of bilateral traumatic fistulae associated with a pseudoaneurysm. Resolution of both fistulae occurred following treatment of one of them by balloon occlusion of the internal carotid artery. This case highlights the importance of considering a more conservative approach to bilateral fistulae or those associated with a pseudoaneurysm. We review other treatment options.- - - - - - - - - - ranking = 1keywords = pseudoaneurysm (Clic here for more details about this article) |
2/28. Successful exclusion of a high internal carotid pseudoaneurysm using the Wallgraft endoprosthesis.A 43-year-old woman presented with a several-month history of transient ischemic attacks 7 years following surgery for a malignant carotid body tumor. angiography revealed a pseudoaneurysm at the distal vein graft anastomosis and a stenosis related to the proximal anastomosis. Due to the extensive previous surgery an endovascular approach was advocated and the pseudoaneurysm was successfully excluded using a covered stent (Wallgraft). This is, to our knowledge, the first time such an approach has been used following carotid body tumor excision.- - - - - - - - - - ranking = 3keywords = pseudoaneurysm (Clic here for more details about this article) |
3/28. Internal carotid artery pseudoaneurysm masquerading as a peritonsillar abscess.Blunt carotid arterial injuries are uncommon. Motor vehicle crashes are the most frequent cause, but this type of vascular injury can be secondary to any direct blow to the neck, intraoral trauma, or strangulation. Types of vascular injuries include dissection, pseudoaneurysm, thrombosis, rupture, and arteriovenous fistula formation. patients with pseudoaneurysm of the internal carotid artery will usually present with neurologic complaints, ranging from the minor to complete stroke. On physical examination, neck hematoma, bruits, pulsatile neck mass, or a palpable thrill may be found. However, in 50% of cases, no external signs of neck trauma are observed. Onset of symptoms may occur within a few hours to several months after the initial injury. angiography is considered the gold standard for diagnosis, but carotid Doppler ultrasound recently has been shown to be very sensitive in detecting these types of injuries. Treatment of pseudoaneurysm is often surgical, with endovascular stenting.- - - - - - - - - - ranking = 3.5keywords = pseudoaneurysm (Clic here for more details about this article) |
4/28. Endovascular management of aneurysm and carotid-cavernous fistulae from gunshot wounds to the skull base and oropharynx.The clinician must be aware of the potential for vascular injury that can result from gunshot wounds to the skull base and oropharynx. These lesions can be life-threatening or can result in irreversible neurologic defects. The goal is early diagnosis and efficient appropriate treatment. Endovascular therapy has been proven to be of great benefit for the treatment of traumatic aneurysms and carotid-cavernous fistulae. Utilizing either a reconstructive or a deconstructive approach, the traumatic lesions can be treated without the morbidity inherent to surgery of the skull base or cavernous sinus. This article discusses the authors' experience with endovascular treatment, explaining in detail the reconstructive and deconstructive approaches and providing clinical examples of the treatment of pseudoaneurysms and carotid-cavernous fistulae.- - - - - - - - - - ranking = 0.5keywords = pseudoaneurysm (Clic here for more details about this article) |
5/28. Direct surgery for posttraumatic carotid-cavernous fistula as a result of an intradural pseudoaneurysm: case report.OBJECTIVE AND IMPORTANCE: Traumatic carotid-cavernous fistula (CCF) is currently treated with interventional neuroradiological embolization procedures. A rare case of posttraumatic CCF that resulted from an intradural pseudoaneurysm is presented. The patient was treated by direct surgery because an embolization procedure was not suitable. CLINICAL PRESENTATION: A 16-year-old boy developed chemosis in the right eye 17 days after a traffic accident. angiography revealed a pseudoaneurysm that arose from the site of origin of the posterior communicating artery, drained directly into the cavernous sinus, and formed a high-flow CCF. INTERVENTION: Direct surgery was performed to repair the arterial laceration at the junction of the internal carotid artery and the posterior communicating artery. A clip was applied along the internal carotid artery. The posterior stump of the damaged posterior communicating artery was also included in the clip. Postoperatively, the CCF and pseudoaneurysm were completely obliterated, and the symptoms were cured. CONCLUSION: awareness of an unusual intradural origin of a CCF and the possibility of a direct surgical treatment should be kept in mind.- - - - - - - - - - ranking = 3.5keywords = pseudoaneurysm (Clic here for more details about this article) |
6/28. Giant cervical internal carotid artery pseudoaneurysm in a child: endovascular treatment.We report a child with a giant upper cervical internal carotid artery pseudoaneurysm presenting with dysphagia, respiratory distress and a sentinel mild epistaxis, then massive epistaxis. rupture of the pseudoaneurysm during treatment occurred, as in one reported case. Prompt endovascular treatment yielded a good outcome.- - - - - - - - - - ranking = 3keywords = pseudoaneurysm (Clic here for more details about this article) |
7/28. Delayed stenosis following placement of a polyethylene terephthalate endograft in the cervical carotid artery. Report of three cases.Three patients with carotid artery (CA) pseudoaneurysms were treated using four polyethylene terephthalate endografts (Wallgraft endoprostheses). Two patients received a single graft and one patient with bilateral pseudoaneurysms received two grafts. Complete occlusion of the pseudoaneurysm with patency of the arterial lumen was achieved following endograft placement in all patients. The clinical follow-up interval ranged from 12 to 18 months and included angiography or ultrasonography studies or both. One patient experienced neurological symptoms, and in-graft stenosis ranging from 50 to 100% occurred in three of the four grafts. Although the Wallgraft endoprosthesis produced good initial results for the treatment of cervical CA pseudoaneurysms, as demonstrated on radiography, it was associated with a high rate of stenosis or occlusion in all three patients.- - - - - - - - - - ranking = 2keywords = pseudoaneurysm (Clic here for more details about this article) |
8/28. postoperative complications of carotid patching: pseudoaneurysm and infection.Patch angioplasty after carotid endarterectomy has been advocated to improve results by decreasing the incidence of recurrent stenosis and postoperative carotid thrombosis. Aneurysmal and infectious complications may be secondary to use of prosthetic materials in arterial reconstruction. We report four patients who developed late operative site complications related to carotid patching. All four of our patients had delayed pseudoaneurysms and three had infection related to the Dacron patch. In a typical case, a 57-year-old who had a right carotid endarterectomy in 1994 presented with a 1-month history of an enlarging right neck mass 7 years later. Imaging revealed a 6 x 4 cm pseudoaneurysm originating from an opening between the patch graft and the old endarterectomized carotid wall. Analysis of the literature disclosed an additional 45 patients who had pseudoaneurysms and/or infection related to carotid patching, most frequently with Dacron. We postulate that a low-grade staphylococcus epidermidis infection of the foreign body patch may be the etiology. Autogenous saphenous vein interposition graft and antimicrobials effective against gram-positive organisms corrected the pseudoaneurysm. Although the benefits of routine carotid patching may include a decrease in restenosis, this advantage must be weighed against the risk of late pseudoaneurysm and/or infection when a prosthetic patch is used to closed the endarterectomy site.- - - - - - - - - - ranking = 4.5keywords = pseudoaneurysm (Clic here for more details about this article) |
9/28. Internal carotid artery pseudoaneurysms: treatment with the Wallgraft endoprosthesis.PURPOSE: To report several cases illustrating the feasibility and mid-term efficacy of deploying a self-expanding stent-graft to treat traumatic ruptures, pseudoaneurysms, and a spontaneous dissection of the internal carotid artery (ICA). case reports: One patient suffered a stab wound and another developed a large pseudoaneurysm years after a gunshot to the neck. The third patient presented with a spontaneous rupture in the setting of fibromuscular dysplasia, and the final patient developed a pseudoaneurysm following carotid endarterectomy in an irradiated neck. All 4 patients were successfully treated with Wallgrafts deployed in the ICA using either an open carotid (first 3 cases) or percutaneous approach (fourth patient). There were no adverse neurological events. During a mean 16-month follow-up (range 6-24), duplex ultrasound and CT scanning found no evidence of restenosis, occlusion, or persistent perfusion of the pseudoaneurysm, which was noted to decrease in all cases. CONCLUSIONS: The thin-walled fabric of the Wallgraft appears capable of completely excluding the pseudoaneurysm, resulting in decreased aneurysm size over time.- - - - - - - - - - ranking = 4.5keywords = pseudoaneurysm (Clic here for more details about this article) |
10/28. Massive epistaxis related to petrous carotid artery pseudoaneurysm after radiation therapy: emergency treatment with covered stent in two cases.Two patients had acute left carotid rupture from radiation therapy-induced pseudoaneurysms, resulting in hemodynamic collapse. Because the patients were semicomatose and in shock, an immediate salvage procedure was needed. Location of the pseudoaneurysm at the skull base made surgical treatment less possible. Endovascular therapy was the treatment of choice. Preserving patency of the carotid artery was a desirable option. The successful use of a covered stent in the emergency treatment of massive epistaxis due to active bleeding from pseudoaneurysm in the petrous internal carotid artery (ICA) is described.- - - - - - - - - - ranking = 3.5keywords = pseudoaneurysm (Clic here for more details about this article) |
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