title: Endovascular treatment of traumatic internal carotid artery pseudoaneurysm.
abstract: BACKGROUND
  Traumatic internal carotid artery pseudoaneurysm (TICAP) is the most common cause of stroke in young adults. The treatment of TICAP with open surgery poses excess risk, thus during last decade endovascular treatment strategies have been applied.
  
  
  OBJECTIVE
  To assess the efficacy and the existing experience of endovascular treatment of TICAP.
  
  
  METHODS
  A systematic review of the literature was undertaken to identify all reported cases of endovascular treatment of TICAP from 1998 to 2015 in MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials.
  
  
  RESULTS
  A total of 193 patients (139 males, 75%) with mean age of 30.8±2.2 years in 23 case studies, were treated for their TICAP with endovascular treatment. The main causes of TICAP were road traffic accidents 51%, assaults 12%, fall from height 8% and other miscellaneous causes were 29%. In 8/23 studies, the patients were operated emergently, in 9/23 at least 1 month after the carotid injury, and in 6/23 the time between the injury and the operation was not reported. The total success rate of pseudoaneurysm occlusion was 84% (162/193). The reported peri-procedural morbidity rate was 6% (11/185; 3 TIA, 7 strokes and 1 subclavian artery dissection), and the peri-operative mortality rate was 1.2% (2/162). Most patients received post-operatively antiplatelet therapy (either single or dual) and the duration of the administration ranged from 3 months to long term. During their follow up (ranging from 4 days to 13 years) only 6 patients required re-intervention, and this was undertaken with endovascular approach.
  
  
  CONCLUSIONS
  Endovascular therapy tends to be an effective option for the treatment of TICAP with low morbidity and mortality rates.
authors.affiliation: Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece. Electronic address: spanos.kon@gmail.com.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Spanos
authors.affiliation: Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Karathanos
authors.affiliation: Department of Anaesthesiology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stamoulis
authors.affiliation: Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Athanasios D
authors.initials: AD
authors.lastname: Giannoukas
mesh_terms: D017541:Aneurysm, False / Q000503:physiopathology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000503:physiopathology / Q000601:surgery*; D020215:Carotid Artery, Internal, Dissection; D018450:Disease Progression; D057510:Endovascular Procedures / Q000379:methods; D006801:Humans; D017410:Practice Guidelines as Topic; D015607:Stents; D020521:Stroke / Q000517:prevention & control*
keywords: Carotid artery pseudoaneurysm; Covered stent; Internal carotid artery