Long-term results of endovascular exclusion of extracranial internal carotid artery aneurysms and dissecting aneurysm.
OBJECTIVE
Surgery remains the standard option to treat symptomatic or complicated aneurysms of the extracranial internal carotid arteries (EICA). When located more distally to the EICA, surgery appears to be very invasive and disabling. Endovascular treatment of high aneurysmal EICA has been poorly reported. We report our experience in this particular field.


METHODS
We treated five EICA endovascularly, using covered stents and stentgrafts in four patients, two males and two females. One male was treated bilaterally. The average age was 59.2 years (39-80). Three patients were symptomatic (two transient ischemic attack and one stroke). Patients were followed by duplex scan, CT scan, or angio MR.


RESULTS
Protecting devices were used in two cases. No in-hospital complication was observed. During follow-up (3.6 +/- 1.3 years), no adverse event was observed and all devices remained patent at duplex scan and angiography. One early endoleak was observed and treated with covered stent extension. No sign of in-stent stenosis was observed. All the aneurysmal sacs thrombosed.


CONCLUSIONS
Covered stents and stentgrafts allow a less invasive approach to treat highly located internal carotid aneurysms. Larger series are needed to assess the role of covered stents in treating aneurysmal EICA as first choice.
Thoracic & Cardiovascular Surgery, Saint Joseph Hospital, 13285 Marseille cedex 08, France. p.bergeron@hopital-saint-joseph.fr
Patrice
P
Bergeron
Patrick
P
Khanoyan
Jean-Pierre
JP
Meunier
Jean-Noël
JN
Graziani
Joel
J
Gay
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000628:therapy*; D000792:Angiography; D000800:Angioplasty, Balloon; D020215:Carotid Artery, Internal, Dissection / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome