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Combined Endovascular/Neurosurgical Therapy of Blister-Like Distal Internal Carotid Aneurysms

Published online by Cambridge University Press:  02 December 2014

D.M. Pelz ,
G.G. Ferguson ,
S.P. Lownie  and
E. Kachur
D.M. Pelz
Affiliation:
Department of Diagnostic Radiology and Nuclear Medicine, London Health Sciences Centre, University Campus, University of Western Ontario, London, Ontario, Canada
G.G. Ferguson
Affiliation:
Department of Clinical Neurological Sciences, London Health Sciences Centre, University Campus, University of Western Ontario, London, Ontario, Canada
S.P. Lownie
Affiliation:
Department of Diagnostic Radiology and Nuclear Medicine, London Health Sciences Centre, University Campus, University of Western Ontario, London, Ontario, Canada
E. Kachur
Affiliation:
Department of Clinical Neurological Sciences, London Health Sciences Centre, University Campus, University of Western Ontario, London, Ontario, Canada
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Abstract

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Objective:

To describe a novel therapeutic strategy for the treatment of “blister-like” aneurysms of the distal internal carotid artery (ICA). Direct surgical treatments of these fragile lesions have been associated with generally poor outcomes.

Methods:

Two consecutive patients presenting with acute subarachnoid hemorrhage from “blister-like” aneurysms were treated with preliminary balloon occlusion of the ICA, followed by surgical trapping of the ICA beyond the aneurysm.

Results:

The treatment resulted in complete thrombosis of both aneurysms with no clinical complications.

Conclusion:

This combined endovascular-neurosurgical approach offers a controlled, safer alternative to primary surgical therapy of “blister-like” aneurysms.

Résumé:

RÉSUMÉ:Objectif:

Décrire une stratégie thérapeutique nouvelle pour le traitement des anévrismes sacciformes de la carotide interne distale (CID). Le traitement chirurgical direct de ces lésions fragiles a été associé à des résultats généralement défavorables.

Méthodes:

Deux patients consécutifs présentant une hémorragie sous-arachnoïdienne aiguë provenant d’anévrismes sacciformes ont été traités par occlusion préliminaire par ballon de la CID, suivie d’un piégeage de la CID au-delà de l’anévrisme.

Résultats:

Le traitement a provoqué la thrombose complète des deux anévrismes sans complication clinique.

Conclusions:

Cette approche endovasculaire et neurochirurgicale combine offre une alternative contrôlée, plus sûre que le traitement chirurgical primaire, des anévrismes sacciformes.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 30 , Issue 1 , February 2003 , pp. 49 - 53
Copyright
Copyright © The Canadian Journal of Neurological 2003

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