Article Figures & Data
Figures
- Fig. 1.
Photograph taken during the operation showing the direct insertion of a 5F sheath into the common carotid artery through the skin.
- Fig. 2.
After the CCA was punctured percutaneously, a 5F sheath introducer of 5 cm was placed in the origin of the ICA. Tracker-38, as a guiding catheter, was inserted in the petrous or cavernous portion of the ICA. A microcatheter via Tracker-38 arrived in the aneurysm.
- Fig. 3.
CT image of cervical region (top). Doppler sonogram (bottom) illustrates blood flow from the carotid artery to the subcutaneous hematoma.
Tables
Characteristics of 27 patients treated with GDC embolization by direct carotid puncture
Patient No./Age (y)/Sex Hunt and Kosnik Grade Location of Aneurysm Size (mm) Neck/Dome Ratio Tortuosity or Dissection Angiographic Results Follow-up (mo) Outcome (GOS) 1/87/M 3 AcomA 11 0.5 Dissection C 2 D 2/85/M 3 AcomA 5 0.4 Tortuosity NR 44 MD 3/76/F 2 Left ICA-OphA 6 0.5 Tortuosity NR 42 GR 4/88/F 2 Right ICA-PcomA 8 0.3 Tortuosity NR 40 GR 5/81/M 2 Left ICA-OphA 5 0.3 Tortuosity C 38 GR 6/84/F 3 AcomA 3 0.5 Dissection NR 8 MD 7/85/F 2 Right MCA 8 0.4 Tortuosity NR 50 MD 8/87/F 2 AcomA 6 0.3 Tortuosity NR 36 GR 9/82/F 2 Right ICA-PcomA 5 0.5 Tortuosity NR 55 GR 10/76/M 0 AcomA 5 0.4 Tortuosity NR 46 GR 11/65/M 0 Right MCA 8 0.4 Tortuosity NR 62 GR 12/81/F 2 Right ICA-PcomA 4 0.3 Tortuosity C 16 GR 13/74/F 0 Left ICA-OphA 6 0.5 Tortuosity NR 26 GR 14/86/M 2 Right MCA 8 0.5 Dissection DF 26 MD 15/79/M 0 Right ICA-PcomA 9 0.5 Tortuosity C 13 GR 16/89/F 2 AcomA 5 0.3 Tortuosity C 15 SD 17/82/F 1 AcomA 4 0.4 Tortuosity C 15 GR 18/77/F 0 Left ICA-PcomA 20 0.5 Dissection DF 9 GR 19/76/M 2 Right ICA-PcomA 4 0.5 Tortuosity NR 9 GR 20/78/F 2 Left ICA-PcomA 7 0.4 Tortuosity NR 44 GR 21/86/F 5 Right ICA-OphA 10 0.5 Tortuosity NR 28 VS 22/86/F 2 AcomA 4 0.4 Tortuosity C 18 GR 23/76/M 0 Left ICA-PcomA 10 0.3 Tortuosity NR 26 GR 24/71/F 0 Left ICA-OphA 7 0.4 Tortuosity DF 32 GR 25/75/F 0 Left ICA-OphA 6 0.3 Tortuosity NR 8 GR 26/72/F 0 Left ICA-PcomA 10 0.5 Tortuosity NR 3 GR 27/74/F 0 AcomA 6 0.4 Tortuosity NR 2 GR Note:—AcomA indicates anterior communicating artery; ICA-OphA, internal carotid artery–ophthalmic artery; ICA-PcomA, internal carotid artery–posterior communicating artery; MCA, middle cerebral artery; Tortuosity, severe arterial tortuosity of aortic arches and cervical carotid artery; Dissection, thoracic aortic dissection; C, complete occlusion; NR, neck remnant; DF, dome filling; GOS, Glasgow Outcome Scale; GR, good recovery; MD, moderately disabled; SD, severely disabled; VS, vegetative survival; D, died; IC-PC,
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