Rishi Gupta1, Ajith J Thomas, Amit Masih, Michael B Horowitz. 1. Department of Neurology, Division of Cerebrovascular Disease, Michigan State University and Sparrow Health System, East Lansing, MI 48824, USA. Rishi.gupta@ht.msu.edu
Abstract
BACKGROUND AND PURPOSE: Extracranial carotid artery pseudoaneurysms are a rare entity with a poorly defined natural history. Treatment has been limited to open surgical repair and limited experience with endovascular repair. We review our experience with the use of stent grafts to treat this disease entity. METHOD: We retrospectively reviewed the interventional databases of two university hospitals (Michigan State University and University of Pittsburgh Medical Center) between 2004 and 2006 to identify patients with carotid pseudoaneurysms that were treated with stent grafts. A total of five patients were identified. RESULTS: Of the five patients treated, four presented with acute bleeding secondary to carcinomatous invasion of the carotid artery, while one presented with thromboembolic events. Four of the five were successfully occluded with stent grafts. The one patient in whom the bleeding could not be stopped with the stent graft expired due to cardiac arrest. There were no peri-procedural complications noted as a result of stent graft placement. CONCLUSIONS: Stent grafts can be utilized to treat pseudoaneurysms safely, but may not always stop active extravasation as an isolated therapy. Long-term data is required to determine the durability of the treatment.
BACKGROUND AND PURPOSE: Extracranial carotid artery pseudoaneurysms are a rare entity with a poorly defined natural history. Treatment has been limited to open surgical repair and limited experience with endovascular repair. We review our experience with the use of stent grafts to treat this disease entity. METHOD: We retrospectively reviewed the interventional databases of two university hospitals (Michigan State University and University of Pittsburgh Medical Center) between 2004 and 2006 to identify patients with carotid pseudoaneurysms that were treated with stent grafts. A total of five patients were identified. RESULTS: Of the five patients treated, four presented with acute bleeding secondary to carcinomatous invasion of the carotid artery, while one presented with thromboembolic events. Four of the five were successfully occluded with stent grafts. The one patient in whom the bleeding could not be stopped with the stent graft expired due to cardiac arrest. There were no peri-procedural complications noted as a result of stent graft placement. CONCLUSIONS: Stent grafts can be utilized to treat pseudoaneurysms safely, but may not always stop active extravasation as an isolated therapy. Long-term data is required to determine the durability of the treatment.