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internal_carotid_artery_aneurysm

Internal carotid artery aneurysm

Types

Treatment

In complex intracranial aneurysm of the internal carotid artery a study showed that regardless of the graft type, the middle cerebral artery pressure (MCAP) ratio (MCAPR) was associated with low-flow related ischemic complications (LRICs), which were related to late neurological worsening (NW) in patients treated by high-flow Extra intracranial bypass surgery graft 1).

Case series

2016

A study included 97 patients harboring a total of 99 unruptured aneurysms of the distal internal carotid artery (ICA) who underwent single-stent implantation and more than 1 session of conventional angiography during follow-up (midterm follow-up only, n = 70; midterm and long-term follow-up, n = 29) between January 2009 and April 2014. The luminal narrowing point was measured using a local thickness map (ImageJ plug-in).

Stent-assisted coil embolization caused dynamic luminal narrowing of approximately 82% of the parent artery diameter on average after 8 months, which was reversed to 91% after 25 months. In addition, luminal narrowing greater than 40% was noticed in 2 (7%) of the 29 patients who experienced spontaneous reversion without additional management during follow-up. Most luminal narrowing changes seen were diffuse.

Luminal narrowing after aneurysm stent-assisted coil embolization is a dynamic process and appears to be a spontaneously reversible event. Routine management of luminal narrowing may not cause adverse events that require additional treatment 2).

1)
Matsukawa H, Tanikawa R, Kamiyama H, Tsuboi T, Noda K, Ota N, Miyata S, Suzuki G, Takeda R, Tokuda S. Risk factors for low-flow related ischemic complications and neurological worsening in patients with complex internal carotid artery aneurysm treated by EC-IC high-flow bypass. World Neurosurg. 2015 Oct 9. pii: S1878-8750(15)01296-6. doi: 10.1016/j.wneu.2015.09.095. [Epub ahead of print] PubMed PMID: 26459703.
2)
Kim YS, Lee SW, Yeom JA, Yoon CH, Baik SK. Angiographic findings of in-stent intimal hyperplasia after stent-assisted coil embolization: are they permanent findings? J Neurosurg. 2016 Feb;124(2):328-333. Epub 2015 Aug 28. PubMed PMID: 26315002.
internal_carotid_artery_aneurysm.txt · Last modified: 2017/09/05 21:25 by administrador