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Case report
Cervical–petrous internal carotid artery pseudoaneurysm presenting with otorrhagia treated with endovascular techniques
  1. Justin R Mascitelli1,
  2. Reade A De Leacy2,
  3. Eric K Oermann1,
  4. Branko Skovrlj1,
  5. Eric E Smouha3,
  6. Sharif H Ellozy4,
  7. Aman B Patel1
  1. 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA
  2. 2Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, USA
  3. 3Department of Otorhinolaryngology, Icahn School of Medicine at Mount Sinai, New York, USA
  4. 4Department of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
  1. Correspondence to Dr Aman B Patel, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA; aman.patel{at}mountsinai.org

Abstract

Cervical–petrous internal carotid artery (CP-ICA) pseudoaneurysms are rare and have different etiologies, presentations, and treatment options. A middle-aged patient with a history of chronic otitis media presented with acute otorrhagia and was found to have a left-sided CP-ICA pseudoaneurysm. The patient was a poor surgical candidate with difficult arterial access. The pseudoaneurysm was treated with stand-alone coiling via a left brachial approach with persistent contrast filling seen only in the aneurysm neck at the end of the procedure. The patient re-presented 12 days later with repeat hemorrhage and rapid enlargement of the neck remnant, and was treated with a covered stent via a transcervical common carotid artery cut-down. A covered stent may provide a more definitive treatment for CP-ICA pseudoaneurysms compared with standalone coiling.

  • Aneurysm
  • Coil
  • Stent

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