title: Internal carotid artery pseudoaneurysms: treatment with the Wallgraft endoprosthesis.
abstract: OBJECTIVE
  To report several cases illustrating the feasibility and mid-term efficacy of deploying a self-expanding stent-graft to treat traumatic ruptures, pseudoaneurysms, and a spontaneous dissection of the internal carotid artery (ICA).
  
  
  METHODS
  One patient suffered a stab wound and another developed a large pseudoaneurysm years after a gunshot to the neck. The third patient presented with a spontaneous rupture in the setting of fibromuscular dysplasia, and the final patient developed a pseudoaneurysm following carotid endarterectomy in an irradiated neck. All 4 patients were successfully treated with Wallgrafts deployed in the ICA using either an open carotid (first 3 cases) or percutaneous approach (fourth patient). There were no adverse neurological events. During a mean 16-month follow-up (range 6-24), duplex ultrasound and CT scanning found no evidence of restenosis, occlusion, or persistent perfusion of the pseudoaneurysm, which was noted to decrease in all cases.
  
  
  CONCLUSIONS
  The thin-walled fabric of the Wallgraft appears capable of completely excluding the pseudoaneurysm, resulting in decreased aneurysm size over time.
authors.affiliation: Department of Vascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Kubaska
authors.forename: Roy K
authors.initials: RK
authors.lastname: Greenberg
authors.forename: Daniel
authors.initials: D
authors.lastname: Clair
authors.forename: Gregory
authors.initials: G
authors.lastname: Barber
authors.forename: Sunita D
authors.initials: SD
authors.lastname: Srivastava
authors.forename: Richard M
authors.initials: RM
authors.lastname: Green
authors.forename: David L
authors.initials: DL
authors.lastname: Waldman
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ouriel
mesh_terms: D000328:Adult; D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D020215:Carotid Artery, Internal, Dissection / Q000601:surgery*; D020216:Carotid-Cavernous Sinus Fistula / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D015607:Stents