Giant cervical carotid artery pseudoaneurysm treated with a covered Stent : Two case reports

Abstract

Objective: To report two cases of a giant extracranial cervical carotid artery pseudoaneurysms treated with covered stents. Case presentation: Case 1: A 72-year-old man receiving palliative care for stomach cancer presented swelling in the neck and a hoarse throat. Angiogram revealed a pseudoaneurysm with a diameter of 5 cm in the cervical carotid artery. The guiding catheter was introduced through the common carotid artery exposed surgically at the neck. A covered stent was placed over the ostium of the pseudoaneurysm. Because endoleak occurred, a bare stent was overlapped inside the covered stent. The final angiogram showed successful exclusion of the pseudoaneurysm. Case 2: A 71-year-old woman with advanced gastric cancer presented neck pain and dyspnea. Angiogram revealed a pseudoaneurysm with a diameter of 6 cm in the cervical carotid artery. A covered stent was placed over the ostium of the pseudoaneurysm. The following day’s angiogram showed re-opacification of the aneurysm due to slip drop of the covered stent. Inserting a bare stent and an additional covered stent successfully excluded the aneurysm. Conclusion: Endovascular treatment with a covered stent is a safe and effective treatment for giant cervical carotid artery pseudoaneurysms. © 2009, The Japanese Society for Neuroendovascular Therapy. All rights reserved.