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    Final Number:

    Saul F Morales-Valero MD; M. Yashar S. Kalani MD, PhD; Felipe Albuquerque MD; Ali R. Zomorodi MD; L. Fernando Gonzalez MD

    Study Design:

    Subject Category:
    Aneurysm/Subarachnoid Hemorrhage

    Meeting: AANS/CNS Cerebrovascular Section 2015 Annual Meeting

    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.


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