Ho Cheol Choi1, Sung Eun Park1, Dae Seob Choi2, Hwa Seon Shin1, Ji Eun Kim1, Hye Young Choi1, Mi Jung Park1, Eun Ha Koh3. 1. Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea. 2. Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea; Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Republic of Korea. Electronic address: choids@gnu.ac.kr. 3. Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
Abstract
BACKGROUND AND PURPOSE: Rupture of the extracranial carotid artery is a rare, but potentially disastrous event. We aimed to review the clinical presentations and radiologic findings of this entity and to evaluate the efficacy of endovascular treatment with covered stent graft. MATERIALS AND METHODS: Since January 2009, eight patients with extracranial carotid artery rupture received endovascular treatment with covered stent graft. We retrospectively reviewed their medical records and radiologic findings. RESULTS: The ruptured sites were in the common carotid artery (n=5), cervical ICA (n=2) and petrous ICA (n=1), respectively. The causes of injury included spontaneous (n=2), carotid blowout syndrome (CBS) (n=2), iatrogenic (n=2) and traumatic (n=2). Technical success and immediate hemostasis were achieved in all cases. Procedure-related complications occurred in 3 patients (37.5%). In a patient, the ipsilateral angular branch of the MCA was occluded during the procedure and it was completely reopened via mechanical thrombectomy without any neurologic deficit. Minor cerebral infarction was developed in 2 patients (25%). During a mean follow-up of 334 days (range 3-2053 days), two patients died: one from recurrent CBS and the other from aspiration pneumonia. CONCLUSIONS: The covered stent grafting is an effective method for the treatment of extracranial carotid artery rupture.
BACKGROUND AND PURPOSE: Rupture of the extracranial carotid artery is a rare, but potentially disastrous event. We aimed to review the clinical presentations and radiologic findings of this entity and to evaluate the efficacy of endovascular treatment with covered stent graft. MATERIALS AND METHODS: Since January 2009, eight patients with extracranial carotid artery rupture received endovascular treatment with covered stent graft. We retrospectively reviewed their medical records and radiologic findings. RESULTS: The ruptured sites were in the common carotid artery (n=5), cervical ICA (n=2) and petrous ICA (n=1), respectively. The causes of injury included spontaneous (n=2), carotid blowout syndrome (CBS) (n=2), iatrogenic (n=2) and traumatic (n=2). Technical success and immediate hemostasis were achieved in all cases. Procedure-related complications occurred in 3 patients (37.5%). In a patient, the ipsilateral angular branch of the MCA was occluded during the procedure and it was completely reopened via mechanical thrombectomy without any neurologic deficit. Minor cerebral infarction was developed in 2 patients (25%). During a mean follow-up of 334 days (range 3-2053 days), two patients died: one from recurrent CBS and the other from aspiration pneumonia. CONCLUSIONS: The covered stent grafting is an effective method for the treatment of extracranial carotid artery rupture.
Authors: Marc Valera Melé; Anna Puigdellívol-Sánchez; Marija Mavar-Haramija; Juan A Juanes-Méndez; Luis San Román; Matteo De Notaris; Giuseppe Catapano; Alberto Prats-Galino Journal: Neurosurg Rev Date: 2018-07-26 Impact factor: 3.042