title: Combined Angio-Seal™ and stenting rescue treatment in a case of iatrogenic common carotid artery dissection during direct puncture for ruptured intracranial aneurysm embolization: a technical note.
abstract: BACKGROUND
  Direct puncture may offer an alternative access for embolization of intracranial aneurysms in patients presenting with tortuous vessels. Nevertheless, major complications such as compressive hematoma and arterial dissection can occur with this technique.
  
  
  METHODS
  A tight common carotid artery (CCA) dissection was seen secondary to direct puncture in a 72-year-old patient who presented with a ruptured anterior communicating artery (ACom) aneurysm. After regular coiling of the aneurysm and using a femoral approach, an Angio-Seal™ device (St Jude Medical, Saint Paul, MN, USA) was placed and a carotid wallstent (Stryker Neurovascular, Fremont, CA, USA) successfully deployed at the dissected CCA, which was followed by good clinical and angiographic outcomes.
  
  
  CONCLUSIONS
  A combined rescue technique combining Angio-Seal insertion and stent deployment was safe and effective for managing iatrogenic carotid artery dissection.
authors: Department of Neuroradiology, Pitié-Salpêtrière University Hospital Center, 47, boulevard de l'Hôpital, 75013 Paris, France.
authors: Christina
authors: C
authors: Iosif
authors: Frédéric
authors: F
authors: Clarençon
authors: Federico
authors: F
authors: Di Maria
authors: Bruno
authors: B
authors: Law-Ye
authors: Lise
authors: L
authors: Le Jean
authors: Laurent
authors: L
authors: Capelle
authors: Jacques
authors: J
authors: Chiras
authors: Nader
authors: N
authors: Sourour
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D011677:Punctures / Q000009:adverse effects*; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics