Endovascular treatment of a carotid dissecting pseudoaneurysm in a patient with Ehlers-Danlos syndrome type IV with fatal outcome.
We present a patient with Ehlers-Danlos syndrome type IV (EDS IV) with a carotid dissecting pseudoaneurysm causing severe carotid stenosis. This lesion was treated endovascularly. Unfortunately, the patient died of remote vascular catastrophes (intracranial hemorrhage and abdominal aortic rupture). This unique case illustrates the perils of endovascular treatment of EDS IV patients and the need for preoperative screening for concomitant lesions. It also shows that a dissecting pseudoaneurysm can feasibly be treated with a covered stent and that closure is effective using Angioseal in patients with EDS IV.
Department of Radiology, Selly Oak Hospital, University Hospital, Birmingham NHS Foundation Trust, Raddlebarn Road, Birmingham, West Midlands B29 6JD, UK. siokpinglim@yahoo.co.uk
Siok Ping
SP
Lim
Martin J
MJ
Duddy
D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D000925:Anticoagulants / Q000008:administration & dosage; D001012:Aorta, Abdominal; D001019:Aortic Rupture / Q000150:complications; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D020212:Carotid Artery Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D000077144:Clopidogrel; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011183:Postoperative Complications; D012720:Severity of Illness Index; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine