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Case series
Endovascular therapy of extracranial carotid artery pseudoaneurysms: case series and literature review
  1. Christopher J Seward1,2,
  2. Travis M Dumont1,2,
  3. Elad I Levy1,2,3,4
  1. 1Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
  2. 2Department of Neurosurgery, Gates Vascular Institute-Kaleida Health, Buffalo, New York, USA
  3. 3Department of Radiology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
  4. 4Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, New York, USA
  1. Correspondence to Dr E I Levy, University at Buffalo Neurosurgery, 100 High Street, Suite B4, Buffalo, NY 14203, USA; elevy{at}ubns.com

Abstract

Background Experience with endovascular therapy of extracranial carotid artery pseudoaneurysm (ECAP) has been growing, and various results suggest it as a suitable treatment option. We present a consecutive case series of patients with ECAPs treated with endovascular therapy, and a pertinent literature review.

Methods A prospectively maintained database of neuroendovascular procedures was retrospectively reviewed for cases of ECAP treated between January 2007 and December 2012. The primary outcome of interest was incidence of periprocedural (within 30 days) neurologic and cardiopulmonary complications. PubMed was searched for relevant endovascular studies from 2000 to 2012 for the review.

Results In our series, 12 patients with 14 ECAPs received stents, with or without coils. No perioperative neurologic or cardiopulmonary complications occurred. Median duration of clinical follow-up was 6.25 months (range 0–50 months), and median duration of imaging follow-up was 6.25 months (range 0–50 months), with eight patients asymptomatic and three showing improved symptoms (one patient with two lesions was lost to follow-up). Literature review revealed an overall primary outcome of 8.6% and no procedure related deaths.

Conclusions Endovascular treatment of ECAP is safe and effective at improving symptoms. There were no perioperative or permanent neurologic sequelae in the 11 patients with follow-up, and all symptomatology related to ECAP improved or resolved with treatment.

  • Aneurysm
  • Artery
  • Technique

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