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Case Reports
. 2012:3:160.
doi: 10.4103/2152-7806.105099. Epub 2012 Dec 26.

Successful treatment of a traumatic carotid pseudoaneurysm with the Pipeline stent: Case report and review of the literature

Peter S Amenta  1 , Robert M Starke, Pascal M Jabbour, Stavropoula I Tjoumakaris, Luis Fernando Gonzalez, Robert H Rosenwasser, Edmund A Pribitkin, Aaron S Dumont
Affiliations
Case Reports

Successful treatment of a traumatic carotid pseudoaneurysm with the Pipeline stent: Case report and review of the literature

Peter S Amenta et al. Surg Neurol Int. 2012.

Abstract

Background: Traumatic intracranial pseudoaneurysms remain one of the most difficult vascular lesions to treat. In the case of traumatic pseudoaneurysms that may not be treated with parent vessel sacrifice, some flow diversion strategy such as stent-assistance or use of a flow diversion device is usually necessary.

Case description: In this study we describe endovascular parent vessel wall-remodeling/endoluminal reconstruction and traumatic pseudoaneurysm thrombosis through the use of the Pipeline stent and review recent reports concerning indications, safety, and efficacy for alternative pathology.

Conclusion: Although currently not routinely employed in the treatment of traumatic pseudoaneurysms, the Pipeline stent may represent a safe and effective treatment alternative achieving complete endoluminal reconstruction of the damaged vessel wall.

Keywords: Aneurysm; endoscopic; flow diversion; hemorrhage; pipeline; pseudoaneurysm; sinusitis; sphenoidostomy; subarachnoid; trauma.

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Figures

Figure 1
Figure 1
(a) Postoperative CT angiogram (CTA) showed no evidence of contrast extravasation or pseudoaneurysm. (b) A CTA repeated one week later, revealed a 2×1.4 mm pseudoaneurysm arising from the left internal carotid artery at the level of the carotid canal dehiscence
Figure 2
Figure 2
(a) Angiography demonstrating traumatic pseudoaneurysm. (b) Angiogram demonstrates demonstrating balloon occlusion (6×9 mm), which the patient passed with hypotensive challenge
Figure 3
Figure 3
(a) At the time of treatment, the pseudoaneurysm had enlarged to 2.8 mm. (b) A 4×16 mm Pipeline stent was deployed across the pseudoaneurysm and the control angiogram demonstrated contrast stasis within the aneurysmal dome. (c) A 4×14 mm Pipeline stent was placed within the first stent to reinforce the construct and the final control angiogram revealed further stasis
Figure 4
Figure 4
Angiogram at 4-month follow-up showed complete obliteration of the pseudoaneurysm and successful reconstruction of the left internal carotid lumen
See this image and copyright information in PMC

References

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