Endovascular treatment of carotid and vertebral pseudoaneurysms with covered stents.

Abstract

BACKGROUND AND PURPOSE:

Endovascular treatment of vascular lesions has revolutionized the treatment of arterial pseudoaneurysms. We describe our experience in treating carotid or vertebral pseudoaneurysms with covered stents.

MATERIALS AND METHODS:

Ten patients with carotid or vertebral pseudoaneurysms treated with self-expanding or balloon-expandable covered stents were retrospectively reviewed after we obtained institutional review board approval. Distal protection devices were not used. All patients except 1 received anticoagulation therapy. Antiplatelet therapy was used in 8 of 10 patients. Follow-up was performed from 5 days to 25 months. Patients were followed with digital subtraction angiography, CT angiography (CTA), and/or sonography (US).

RESULTS:

Pseudoaneurysm occlusion was obtained in all 10 patients. None of the pseudoaneurysms recanalized during the follow-up period. One patient had a distal embolization to the middle cerebral artery despite anticoagulation and antiplatelet therapy. One patient who did not receive any anticoagulation had stent occlusion at 4.5 months. Anticoagulation was stopped after 6 months in 2 patients with persistent stent patency and no neurologic complications for >1 year. Both US and CTA were useful for extracranial stent surveillance. CTA was helpful for intracranial stent surveillance.

CONCLUSION:

In this small series, the use of covered stents allowed safe and effective treatment of pseudoaneurysms occurring in the cervical and cephalic segments of the carotid and vertebral arteries.

• Authors: A C Yi, E Palmer, G Y Luh, J P Jacobson, D C Smith
• Journal: AJNR. American journal of neuroradiology (AJNR Am J Neuroradiol) Vol. 29 Issue 5 Pg. 983-7 (May 2008) ISSN: 1936-959X [Electronic] United States
• PMID: 18296552 (Publication Type: Clinical Trial, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Aneurysm, False (diagnosis, surgery)
• Blood Vessel Prosthesis
• Carotid Artery Injuries (diagnosis, surgery)
• Female
• Humans
• Male
• Middle Aged
• Stents
• Treatment Outcome
• Vertebral Artery (surgery)