title: Cavernous carotid aneurysms: a new treatment paradigm in the era of flow diversion.
abstract: Cavernous carotid aneurysms can cause significant symptomatology through mass effect and may rupture, resulting in carotid-cavernous fistula or epistaxis. Traditional treatment options included endovascular or surgical parent vessel occlusion, or embolization; in the last decade, the development of flow-diverting stents has changed the management paradigm for these lesions. Areas covered: In this review, we summarize the natural history, clinical presentation, and evolution of treatment options for cavernous carotid aneurysms and discuss developments likely to influence treatment strategies in the future. We performed a Medline search for relevant review articles and original reports and additional searches based on review of referenced articles, abstracts, and conference presentations. Expert commentary: Long-term data are still required to fully assess the efficacy of endoluminal reconstruction using flow diversion, but this approach appears to offer an attractive therapy for many cavernous carotid aneurysms requiring intervention.
authors.affiliation: a Department of Neurological Surgery , University of Virginia , Charlottesville , VA , USA.
authors.forename: Daniel M S
authors.initials: DM
authors.lastname: Raper
authors.affiliation: a Department of Neurological Surgery , University of Virginia , Charlottesville , VA , USA.
authors.forename: Dale
authors.initials: D
authors.lastname: Ding
authors.affiliation: b Department of Neurosurgery , University of Miami Miller School of Medicine, University of Miami Hospital, Jackson Memorial Hospital, Miami Children's Hospital , Miami , FL , USA.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Peterson
authors.affiliation: c Department of Neurosurgery , Rush School of Medicine , Chicago , IL , USA.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Crowley
authors.affiliation: a Department of Neurological Surgery , University of Virginia , Charlottesville , VA , USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Liu
authors.affiliation: d Department of Neurosurgery , Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Nohra
authors.initials: N
authors.lastname: Chalouhi
authors.affiliation: e Department of Neurological Surgery , University of Iowa , Iowa City , IA , USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Hasan
authors.affiliation: f Department of Neurological Surgery , Tulane University , New Orleans , LA , USA.
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Dumont
authors.affiliation: d Department of Neurosurgery , Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
authors.affiliation: b Department of Neurosurgery , University of Miami Miller School of Medicine, University of Miami Hospital, Jackson Memorial Hospital, Miami Children's Hospital , Miami , FL , USA.|g Department of Radiology , University of Miami Miller School of Medicine, University of Miami Hospital and Jackson Memorial Hospital , Miami , FL , USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Starke
mesh_terms: D000783:Aneurysm; D002340:Carotid Artery Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D020216:Carotid-Cavernous Sinus Fistula / Q000209:etiology; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D006801:Humans; D015607:Stents
keywords: Cavernous; aneurysm; carotid; carotid cavernous fistula; coil; endovascular; flow diversion; microsurgery; occlusion; stent