title: Cervical-petrous internal carotid artery pseudoaneurysm presenting with otorrhagia treated with endovascular techniques.
abstract: Cervical-petrous internal carotid artery (CP-ICA) pseudoaneurysms are rare and have different etiologies, presentations, and treatment options. A middle-aged patient with a history of chronic otitis media presented with acute otorrhagia and was found to have a left-sided CP-ICA pseudoaneurysm. The patient was a poor surgical candidate with difficult arterial access. The pseudoaneurysm was treated with stand-alone coiling via a left brachial approach with persistent contrast filling seen only in the aneurysm neck at the end of the procedure. The patient re-presented 12 days later with repeat hemorrhage and rapid enlargement of the neck remnant, and was treated with a covered stent via a transcervical common carotid artery cut-down. A covered stent may provide a more definitive treatment for CP-ICA pseudoaneurysms compared with standalone coiling.
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Justin R
authors.initials: JR
authors.lastname: Mascitelli
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Reade A
authors.initials: RA
authors.lastname: De Leacy
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Eric K
authors.initials: EK
authors.lastname: Oermann
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Branko
authors.initials: B
authors.lastname: Skovrlj
authors.affiliation: Department of Otorhinolaryngology, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Smouha
authors.affiliation: Department of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Sharif H
authors.initials: SH
authors.lastname: Ellozy
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Aman B
authors.initials: AB
authors.lastname: Patel
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods*; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010579:Petrous Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography
keywords: Aneurysm; Coil; Stent