Covered stent-graft treatment of traumatic internal carotid artery pseudoaneurysms: a review

Cardiovasc Intervent Radiol. Nov-Dec 2006;29(6):958-68. doi: 10.1007/s00270-005-0367-7.

Abstract

Objective: To review the literature concerning the management with placement of covered stent-grafts of traumatic pseudoaneurysms of the extracranial internal carotid artery (ICA) resulting from penetrating craniocervical injuries or skull base fractures.

Method: We have reviewed, from the Medline database, all the published cases in the English literature since 1990 and we have added a new case.

Results: We identified 20 patients with traumatic extracranial ICA pseudoaneurysms due to penetrating craniocervical injuries or skull base fractures who had been treated with covered stent-graft implantation. Many discrepancies have been ascertained regarding the anticoagulation therapy. In 3 patients the ICA was totally occluded in the follow-up period, giving an overall occlusion rate 15%. No serious complication was reported as a result of the endovascular procedure.

Conclusion: Preliminary results suggest that placement of stent-grafts is a safe and effective method of treating ICA traumatic pseudoaneurysms resulting from penetrating craniocervical injuries or skull base fractures. The immediate results are satisfactory when the procedure takes place with appropriate anticoagulation therapy. The periprocedural morbidity and mortality and the early patency are also acceptable. A surveillance program with appropriate interventions to manage restenosis may improve the long-term patency.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology
  • Aneurysm, False / surgery*
  • Anticoagulants / therapeutic use
  • Blood Vessel Prosthesis Implantation
  • Carotid Artery Injuries / diagnostic imaging
  • Carotid Artery Injuries / etiology
  • Carotid Artery Injuries / surgery*
  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Artery, Internal / surgery*
  • Coated Materials, Biocompatible / therapeutic use*
  • Combined Modality Therapy
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / etiology
  • Head Injuries, Penetrating / complications
  • Head Injuries, Penetrating / diagnostic imaging
  • Head Injuries, Penetrating / surgery
  • Humans
  • Male
  • Polytetrafluoroethylene / therapeutic use
  • Radiography
  • Skull Fracture, Basilar / complications
  • Skull Fracture, Basilar / diagnostic imaging
  • Skull Fracture, Basilar / surgery
  • Stents*
  • Vascular Patency

Substances

  • Anticoagulants
  • Coated Materials, Biocompatible
  • Polytetrafluoroethylene