Combined open and endovascular treatment of a saccular aneurysm and redundant loop of the internal carotid artery.
We report the unusual case of a woman with a saccular aneurysm of the distal cervical internal carotid artery arising just distal to a kink and a 360 degrees redundant loop. The retromandibular position of the aneurysm would have mandated a complex surgical procedure. A purely endovascular approach was not possible owing to the difficulty to pass any kind of device beyond the redundant loop. A hybrid approach, in which the kink was surgically straightened and the saccular aneurysm coiled after stenting of its orifice, was therefore used to treat this challenging case. A review of the literature supporting this approach is discussed.
Trinidad-Hernández
Magdiel
M
Department of Surgery, University of Illinois/Metropolitan Group Hospitals, Advocate Lutheran General Hospital, 1775 Dempster Street, 8 South Building, Park Ridge, 60068-1174, USA.
Introcaso
Joseph H
JH
White
John V
JV
D000368:Aged; D002342:Carotid Artery, External / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D002404:Catheterization; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008026:Ligation; D018810:Magnetic Resonance Angiography; D011859:Radiography; D015607:Stents; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures / Q000379:methods*