title: Efficacy of a Self-Expandable Porous Stent as the Sole Curative Treatment for Extracranial Carotid Pseudoaneurysms.
abstract: OBJECTIVE
  Extracranial carotid pseudoaneurysms are uncommon vascular lesions. Even with conservative management complications can happen, such as delayed cerebral embolization or symptoms due to flow limitation. Although endovascular therapy can be curative, literature demonstrating a preferred technique is scant. Our goal was to evaluate the use of 1 technique only-the deployment of overlapping self-expandable porous stents-to treat a series of extracranial carotid pseudoaneurysms.
  
  
  METHODS
  From 2008 to 2014, 14 consecutive cases of symptomatic extracranial carotid pseudoaneurysms were managed with single or multilayer porous stents at our institution. Each patient underwent a standardized angiographic follow-up at 6 months. Twelve patients also received a follow-up computed tomography angiogram at 12 months, and yearly thereafter (median radiographic follow-up, 38 months). The total clinical follow-up period ranged between 6 and 69 months (median, 46 months).
  
  
  RESULTS
  In our series, each of the extracranial carotid pseudoaneurysms appeared to be the result of carotid artery dissection with associated carotid stenosis at the origin of every pseudoaneurysm. Endovascular treatment consisted of 1-3 layers of self-expandable porous stents placed without balloon angioplasty. Immediately after stenting angiographic images were notable for stagnant opacification of the pseudoaneurysm through the stent(s). All pseudoaneurysms were completely obliterated by the 6-month follow-up angiogram and remained so throughout the radiographic follow-up period. Complications were minimal, consisting of 1 patient developing a mild Horner's syndrome after treatment that resolved during clinical follow-up.
  
  
  CONCLUSIONS
  Extracranial carotid pseudoaneurysms can be successfully obliterated with the use of porous, self-expandable stents.
authors.affiliation: Department of Neurosurgery, University of Texas Medical School at Houston, Houston, Texas, USA. Electronic address: peng.r.chen@uth.tmc.edu.
authors.forename: Peng Roc
authors.initials: PR
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, University of Texas Medical School at Houston, Houston, Texas, USA; Department of Neurology, University of Texas Medical School at Houston, Houston, Texas, USA.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Edwards
authors.affiliation: Department of Neurosurgery, University of Texas Medical School at Houston, Houston, Texas, USA.
authors.forename: Aditya
authors.initials: A
authors.lastname: Sanzgiri
authors.affiliation: Department of Neurosurgery, University of Texas Medical School at Houston, Houston, Texas, USA.
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Day
mesh_terms: D000328:Adult; D001807:Blood Vessel Prosthesis; D020212:Carotid Artery Injuries / Q000175:diagnosis* / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016062:Porosity; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult
keywords: Dissection; Extracranial carotid; Flow directing; Overlapping; Porous stents; Pseudoaneurysm