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P002/21  Endovascular treatment of traumatic paraclinoid internal carotid artery aneurysm in 4 years old patient with flow diverting stent, case report
  1. Ehsan Mohammad Hosseini1,
  2. Ali Reza Rasekhi2,
  3. Susan Andalibi2,
  4. Arman Sourani3
  1. 1Shiraz university of medical sciences, neurosurgery department, Namazi hospital, shiraz, Iran
  2. 2Namazi Hospital, Shiraz University of medical Sciences, Shiraz, Iran
  3. 3 Isfahan University of medical sciences, Neurosurgery, Isfahan, Iran


Introduction Pediatric intracranial aneurysms are rare and have different pathophysiology from adult counterpart.

Arterial dissection and trauma are main etiology of pediatric aneurysms.

Aim of Study Efficacy and safety of Flow Diverting Stent (FDS) in traumatic pediatric aneurysm.

Methods 4 y/o girl with car accident in 3 months ago, refer to our center for workup of suprasellar lesion. (figure 1)

Initial brain CT after trauma revealed Lefort with skull base fracture and Sub Arachnoid Hemorrhage (SAH), but without neurologic deficit and patient was conscious. (figure 2)

In this setting maxillofacial surgery was done. (figure 3)

Neurovascular assessment was not performed in this stage.

Brain CTA showed large size and partial thrombotic paraclinoid aneurysm of internal carotid artery (ICA). (figure 4)

We use a body weight adapted dosage with 2 mg ASA and 1 mg Clopidogrel per kilogram as initial dosage for 5 days before stenting.

We deployed a FDS 4*23 mm from communicating segment of ICA to the cavernous part to complete overlap of aneurysm neck. (figure 5)

Results Patient discharged 2 days after stenting without any neurologic deficit.

We continue dual antiplatelet for 6 months.

Total obliteration of aneurysm with patency of carotid is visible after 9 months with F/U brain CTA. (figure 6)

Conclusion Endovascular treatment of pediatric cerebral aneurysm with FDS seems to be safe and effective and comparable with adult group. But further studies are needed to evaluate long term outcome.

Disclosure of Interest Nothing to disclose

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