Covered stent deployment for a recurrent cervical internal carotid artery aneurysm referencing angioscopy: illustrative case.

Hiromichi Hayami, Kenji Fukutome, Shuta Aketa, Junji Fukumori, Takaaki Mitsui, Yuki Shiraishi, Ryuta Matsuoka, Naoki Mori, Rinsei Tei, Yasushi Shin, Yasushi Motoyama
{"title":"Covered stent deployment for a recurrent cervical internal carotid artery aneurysm referencing angioscopy: illustrative case.","authors":"Hiromichi Hayami, Kenji Fukutome, Shuta Aketa, Junji Fukumori, Takaaki Mitsui, Yuki Shiraishi, Ryuta Matsuoka, Naoki Mori, Rinsei Tei, Yasushi Shin, Yasushi Motoyama","doi":"10.3171/CASE24383","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Extracranial carotid artery aneurysms (ECAAs) are rare, and treatment guidelines are lacking. Few reports on endovascular treatments performed for ECAAs exist.</p><p><strong>Observations: </strong>A 73-year-old woman with a left giant cervical internal carotid artery aneurysm was treated with overlapping closed-cell stents. The aneurysm regrew 1 year after the treatment, and then a covered stent was deployed. Angioscopy was performed to confirm neointimal development to determine the appropriate stent position before the retreatment, and it revealed that the stent struts were embedded in thick neointima for the most part but that the neointima was thin around the aneurysm neck. Multiple holes connecting to the aneurysm were observed between the stent struts. A covered stent overlapped inside the closed-cell stents, and blood flow into the aneurysm completely disappeared.</p><p><strong>Lessons: </strong>When deploying the covered stent for recurrent aneurysms, angioscopy is useful for confirming neointimal development and determining the appropriate stent length and position. Angioscopic observations suggest that using stents with a higher mesh density and smaller pore size can reduce the neck hole size of the aneurysm and may achieve complete occlusion of the aneurysm. https://thejns.org/doi/10.3171/CASE24383.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 12","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418031/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurosurgery. Case lessons","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3171/CASE24383","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Extracranial carotid artery aneurysms (ECAAs) are rare, and treatment guidelines are lacking. Few reports on endovascular treatments performed for ECAAs exist.

Observations: A 73-year-old woman with a left giant cervical internal carotid artery aneurysm was treated with overlapping closed-cell stents. The aneurysm regrew 1 year after the treatment, and then a covered stent was deployed. Angioscopy was performed to confirm neointimal development to determine the appropriate stent position before the retreatment, and it revealed that the stent struts were embedded in thick neointima for the most part but that the neointima was thin around the aneurysm neck. Multiple holes connecting to the aneurysm were observed between the stent struts. A covered stent overlapped inside the closed-cell stents, and blood flow into the aneurysm completely disappeared.

Lessons: When deploying the covered stent for recurrent aneurysms, angioscopy is useful for confirming neointimal development and determining the appropriate stent length and position. Angioscopic observations suggest that using stents with a higher mesh density and smaller pore size can reduce the neck hole size of the aneurysm and may achieve complete occlusion of the aneurysm. https://thejns.org/doi/10.3171/CASE24383.

参考血管造影,为复发性颈内动脉瘤部署覆盖支架:示例病例。
背景:颅外颈动脉动脉瘤(ECAA)非常罕见,而且缺乏治疗指南。关于 ECAA 的血管内治疗的报道也很少:一位 73 岁的女性患有左侧颈内动脉巨大动脉瘤,她接受了重叠式闭孔支架治疗。治疗 1 年后,动脉瘤重新生长,随后又植入了一个覆盖支架。血管造影检查确认了新内膜的发育情况,以确定再治疗前支架的适当位置,结果显示支架支柱大部分嵌入厚厚的新内膜中,但动脉瘤颈周围的新内膜较薄。在支架支柱之间观察到多个与动脉瘤相连的孔。覆盖支架重叠在闭孔支架内,流入动脉瘤的血流完全消失:启示:在使用覆盖支架治疗复发性动脉瘤时,血管造影有助于确认新血管的发育情况,并确定适当的支架长度和位置。血管造影观察结果表明,使用网眼密度较高、孔径较小的支架可以缩小动脉瘤颈部的孔径,并可能实现动脉瘤的完全闭塞。https://thejns.org/doi/10.3171/CASE24383。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
0.40
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信