title: Concomitant endovascular treatment of concomitant extracranial carotid stenosis and intracranial aneurysm. Our experience.
abstract: Angioplasty and stenting are emerging alternative treatments to endarterectomy for carotid stenosis. The increasing number of procedures performed carries an increased diagnosis rate of associated asymptomatic intracranial aneurysms, resulting in a clinical and therapeutic dilemma, not fully solved in the literature. When an incidental lesion is found, the first question is whether it is necessary to treat it or not? If treatment is decided, the next question is which should be treated first, the intra or the extracranial lesion? We review our experience and the literature and discuss our preferred approach of single-procedure carotid stenting and aneurysm coiling, which we believe is feasible, safe and effective constituting an option when confronted with this difficult therapeutic dilemma.
authors.affiliation: Diagnostic and Therapeutic Neuroradiology Unit, University General Hospital; Alicante, Spain - jigl8@hotmail.com.
authors.forename: J I
authors.initials: JI
authors.lastname: Gallego León
authors.forename: L
authors.initials: L
authors.lastname: Concepción Aramendía
authors.forename: F
authors.initials: F
authors.lastname: Ballenilla Marco
authors.forename: J C
authors.initials: JC
authors.lastname: Vázquez Suárez
references.citation: Stroke. 1999 Oct;30(10):2086-93
references.pmid: 10512911
references.citation: J Neurosurg Sci. 1997 Sep;41(3):257-62
references.pmid: 9444578
references.citation: Neurology. 2000 Jul 25;55(2):307-9
references.pmid: 10908914
references.citation: Lancet. 2003 Jul 12;362(9378):103-10
references.pmid: 12867109
references.citation: South Med J. 2006 Jul;99(7):757-8
references.pmid: 16866060
references.citation: Ann Surg. 1984 Jul;200(1):70-3
references.pmid: 6732329
references.citation: Acta Neurochir (Wien). 1996;138(12):1386-90
references.pmid: 9030344
references.citation: N Engl J Med. 1998 Dec 10;339(24):1725-33
references.pmid: 9867550
references.citation: J Vasc Surg. 1985 Jan;2(1):158-64
references.pmid: 3965749
references.citation: J Neurol Neurosurg Psychiatry. 2005 Feb;76(2):234-9
references.pmid: 15654039