Autologous vein-covered stent repair of a cervical internal carotid artery pseudoaneurysm: technical case report

Neurosurgery. 1998 Feb;42(2):408-12; discussion 412-3. doi: 10.1097/00006123-199802000-00138.

Abstract

Objective and importance: Stenting of a cervical internal carotid pseudoaneurysm is presented using a stent covered with saphenous vein. This procedure resulted in immediate exclusion of the aneurysm and maintained patency of the carotid artery.

Clinical presentation: A gunshot to the neck resulted in airway obstruction and respiratory arrest with neurological injury in a male patient. Angiographic investigation revealed an enlarging cervical internal carotid pseudoaneurysm, possibly the source of a cerebral embolism. Anticoagulation had to be stopped because of bleeding complications. A decision was made to conduct definitive percutaneous treatment of the pseudoaneurysm.

Technique: A Palmaz stent (JJIS, Warren, NJ) was covered with saphenous vein harvested from the patient's leg. Using standard technique and a simple innovation for stent construct introduction into the sheath, the vein-covered stent was placed across the opening of the aneurysm and dilated into position with a balloon.

Conclusion: Immediate exclusion of a cervical internal carotid pseudoaneurysm was performed using an autologous vein-covered stent. One-month follow-up confirmed continued exclusion of the pseudoaneurysm and carotid patency without stenosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aneurysm, False / diagnosis
  • Aneurysm, False / surgery*
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / surgery*
  • Cerebral Angiography
  • Equipment Design
  • Fluoroscopy
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neck
  • Saphenous Vein / transplantation*
  • Stents*
  • Subtraction Technique
  • Transplantation, Autologous