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Case Reports
. 2025 Jun 13:10:e20240034.
doi: 10.22575/interventionalradiology.2024-0034. eCollection 2025.

Ruptured Infected Pseudoaneurysms of Bilateral Carotid Artery Treated with Viabahn Stent Graft: A Case Report

Chika Somagawa  1 , Hideki Ishimaru  1 , Yoichi Morofuji  2 , Taiga Oka  3 , Satomi Yoshimi  1 , Takamasa Nishimura  3 , Shuto Miyamura  3 , Maki Hirao  3 , Tomoki Nakano  3 , Ryo Toya  1
Affiliations
Case Reports

Ruptured Infected Pseudoaneurysms of Bilateral Carotid Artery Treated with Viabahn Stent Graft: A Case Report

Chika Somagawa et al. Interv Radiol (Higashimatsuyama). .

Abstract

A 74-year-old man who had received Bacillus Calmette-Guérin therapy for bladder cancer developed vasovagal syncope. Contrast-enhanced computed tomography showed multiple pseudoaneurysms in the left internal carotid artery, aorta, and right common femoral artery, which were considered to be infected aneurysms. Parent artery occlusion was planned for the left internal carotid artery, but the balloon occlusion test was not possible because of the patient's restlessness; therefore, the patient was treated with a Viabahn stent graft. Approximately 1 month later, another ruptured pseudoaneurysm occurred in the right internal carotid artery, which was also treated with a Viabahn stent graft. The patient did not experience rebleeding or complications such as cerebral infarction. Viabahn may be an effective alternative for the management of carotid artery-infected aneurysms.

Keywords: carotid pseudoaneurysm; stent graft; viabahn.

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Conflict of interest statement

None

Figures

Figure 1.
Figure 1.
Case: A 74-year-old man. A CT scan showed a large hematoma in the left neck (white arrow) (a). CECT shows a pseudoaneurysm at the origin of the left ICA (arrowheads) (b). CTA of lateral view (maximum intensity projection) showing a large pseudoaneurysm protruding dorsally from the base of the left ICA (black arrow) (c). CECT: contrast-enhanced CT
Figure 2.
Figure 2.
A schematic drawing of the balloon-anchoring technique. Using a 0.035-inch guidewire, a balloon catheter is navigated up to the CCA, and the balloon is inflated and fixed, avoiding irritation of the aneurysm (left). Next, a pulling force is applied to the fixed balloon to straighten the balloon catheter (middle). While pulling the balloon catheter, a 7-Fr guiding sheath can be tracked up to the CCA by pushing it (right).
Figure 3.
Figure 3.
Case: A 74-year-old man. The lateral view of the left common carotid angiography (from a 7-Fr guiding sheath) shows a large pseudoaneurysm at the base of the ICA (arrow) (a). A type I endoleak was noted immediately after placement of the Viabahn stent graft (arrowheads) (b); however, the endoleak completely disappeared after post-dilation with a balloon catheter (c).
Figure 4.
Figure 4.
Case: A 74-year-old man. CECT (a: axial, b: coronal) approximately 1 month after placement of a Viabahn in the left ICA showing a pseudoaneurysm (white arrow) in the right ICA and surrounding hematoma protruding inward. The frontal view of the right common carotid angiography shows the pseudoaneurysm (black arrow) (c). The frontal view of the right common carotid angiography immediately after embolization of the right ECA to prevent a type II endoleak followed by Viabahn implantation (d) does not show the pseudoaneurysm. CECT: contrast-enhanced CT
Figure 5.
Figure 5.
Case: A 74-year-old man: CECT (curved multiplanar reformat) of the right (a: frontal view) and left (b: lateral view) CCA approximately 4 months after placement of the Viabahn in the left ICA does not depict any pseudoaneurysm. CECT: contrast-enhanced CT
See this image and copyright information in PMC

References

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