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Case Reports
. 2015 Jun 26;2(3):93-96.
doi: 10.2176/nmccrj.2014-0432. eCollection 2015 Jul.

Overlapped Stenting for Treatment of an Extracranial Carotid Artery Aneurysm

Kiyoshi Tsuji  1 , Norihito Fukawa  1 , Nobuhiro Nakagawa  1 , Tomonari Yabuuchi  1 , Naoki Nakano  1 , Amami Kato  1
Affiliations
Case Reports

Overlapped Stenting for Treatment of an Extracranial Carotid Artery Aneurysm

Kiyoshi Tsuji et al. NMC Case Rep J. .

Abstract

Extracranial carotid artery aneurysms (ECAAs) are rare, and their treatment is very difficult and challenging. The case of a 59-year-old woman who presented with a pulsatile mass on the left side of her neck, was diagnosed with a left-sided giant thrombosed common carotid artery aneurysm, and underwent definitive treatment by overlapped stenting, is presented. Overlapped stenting is a safe and an effective treatment procedure for ECAA. A covered stent would theoretically be reasonable and immediately effective, but its long-term patency remains unknown. Therefore, in patients lacking ischemic tolerance and those not requiring urgent intervention, overlapped stenting using uncovered stents is preferable.

Keywords: endovascular treatment; extracranial carotid artery aneurysm; overlapped stenting; uncovered stent.

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Conflict of interest statement

Conflicts of Interest Disclosure The authors declare that they have no conflicts of interest. All authors who are members of The Japan Neurosurgical Society (JNS) have registered online Self-reported COI Disclosure Statement Forms through the website for JNS members.

Figures

Fig. 1
Fig. 1
A: Axial source image of three-dimensional computed tomography angiography (3D-CTA) showing a giant thrombosed aneurysm of the left common carotid artery (CCA). B: Volume-rendered 3D-CTA image (left anterior oblique 30° view) showing severe calcification of the carotid arteries bilaterally and a giant thrombosed aneurysm in the left CCA. There is also near occlusion of the right internal carotid artery (ICA). Arrow: near occlusion of the right ICA, arrowhead: thrombosed area of the aneurysm.
Fig. 2
Fig. 2
A: Right carotid angiogram (lateral view) shows near occlusion of the right internal carotid artery (ICA). B: Left carotid angiogram (lateral view) before treatment. Because of severe atherosclerosis involving the origin of the left ICA and the left common carotid artery, there is ectatic dilation and severe stenosis proximal to the aneurysm (arrow: stenotic site). C: Left carotid angiogram (lateral view) just after placement of the two stents. Blood flow to the aneurysm has markedly decreased, and the stenotic site seen proximal to the aneurysm is now sufficiently dilated. D: Left carotid angiogram (lateral view) at follow-up 6 months after treatment. There is absolutely no blood flow to the aneurysm.
Fig. 3
Fig. 3
A, B: Carotid ultrasound before (A) and 1 month after (B) endovascular treatment. There is complete thrombosis of the aneurysm in the carotid ultrasound 1 month post-procedure, and the aneurysm size appears smaller than before the procedure.
See this image and copyright information in PMC

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