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Case Reports
. 2003 Jun-Jul;24(6):1230-3.

Direct percutaneous puncture of a cervical internal carotid artery aneurysm for coil placement after previous incomplete stent-assisted endovascular treatment

Turgut Berkmen  1 , Neil Troffkin, Ajay K Wakhloo
Affiliations
Case Reports

Direct percutaneous puncture of a cervical internal carotid artery aneurysm for coil placement after previous incomplete stent-assisted endovascular treatment

Turgut Berkmen et al. AJNR Am J Neuroradiol. 2003 Jun-Jul.

Abstract

Direct percutaneous puncture for coil placement has been described for visceral aneurysms, but the procedure has not been previously reported for aneurysms of the head and neck. We report a case in which stent-assisted endovascular treatment was successfully combined with direct puncture for additional coil placement to treat a symptomatic giant aneurysm of the cervical internal carotid artery.

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Figures

F<sc>ig</sc> 1.
Fig 1.
Selective left carotid angiogram shows a giant dissecting aneurysm of the cervical ICA. The neck of the aneurysm measures 10 mm. Stenosis and wall irregularities of the ICA are at the level of the aneurysm neck (arrow).
F<sc>ig</sc> 2.
Fig 2.
The stent is positioned across the neck of the aneurysm jailing the microcatheter, which has been placed inside the aneurysm (arrowheads).
F<sc>ig</sc> 3.
Fig 3.
Follow-up arteriogram acquired 1 month after the initial procedure shows most parts of the aneurysm thrombosed, but the neck is patent (arrow).
F<sc>ig</sc> 4.
Fig 4.
Radiograph, anteroposterior projection, shows a needle placed percutaneously into the aneurysm (arrow). A microcatheter has been navigated through the needle for coil placement.
F<sc>ig</sc> 5.
Fig 5.
Angiograms in lateral (A) and frontal (B) views acquired following percutaneous coil placement show no filling of the aneurysm with patent ICA. Note some coils are projecting into the stented segment.
See this image and copyright information in PMC

References

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