Internal carotid artery pseudoaneurysms: treatment with the Wallgraft endoprosthesis.
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.
Kubaska
Stephen M
SM
Department of Vascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Greenberg
Roy K
RK
Clair
Daniel
D
Barber
Gregory
G
Srivastava
Sunita D
SD
Green
Richard M
RM
Waldman
David L
DL
Ouriel
Kenneth
K
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