Introduction: Aneurysms of the extracranial carotid artery are rare. Usually present after a stroke or TIA or as a sequel of a dissection. Various treatment strategies have been described including surgical repair, conservative management and endovascular treatment. However, due to the limited data available, the best option is yet to be established.
Methods: Retrospective review of a prospectively maintained database, from 2009- 2014. Collected data included patient demographic characteristics, treatment details, complications and outcome.
Results: Six patients with extracranial carotid aneurysms undergoing endovascular treatment were identified (Table 1). All pseudoaneurysms were associated with carotid dissection or recanalization of a previous occlusion. All patients were treated using standalone stenting. Three patients had laser cut stents, 2 had a braided design and 1 had a covered stent. One intraprocedural complication occurred, involving stent migration into a large aneurysmal sac, rescued with a longer “anchoring” stent, without consequences. The mean follow-up period was 12 months. At last follow-up, no recurrences or clinical complications were found.
Conclusions: Standalone treatment with endovascular stenting of extracranial carotid pseudoaneurysms constitutes a safe and effective measure. This treatment strategy compares favorably to surgical repair given its less invasive nature and excellent patient outcomes.
Patient Care: Recognize the benefits of standalone stenting as treatment alternative for carotid pseudoaneurysms. Although a small series, no difference between laser cut and braided stent design was found
Complete aneurysm occlusion was obtained in all patients.
Learning Objectives: By the conclusion of this session, participants should be able to:
Recognize that carotid pseudoaneurysms can develop after carotid dissection and can be treated successfully by standalone stenting.