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Brzegowy P, Chukwu O, Ciuk K, et al. Ineffective endovascular treatment of a giant internal carotid artery aneurysm. Pol J Radiol. 2020;85:e323-e327doi: 10.5114/pjr.2020.96979.
Brzegowy, P., Chukwu, O., Ciuk, K., Urbanik, A., Popiela, T., Kwinta, B., & Łasocha, B. (2020). Ineffective endovascular treatment of a giant internal carotid artery aneurysm. Polish journal of radiology, 85e323-e327. https://doi.org/10.5114/pjr.2020.96979
Brzegowy, Paweł, et al. "Ineffective endovascular treatment of a giant internal carotid artery aneurysm." Polish journal of radiology vol. 85 (2020): e323-e327. doi: https://doi.org/10.5114/pjr.2020.96979
Brzegowy P, Chukwu O, Ciuk K, Urbanik A, Popiela T, Kwinta B, Łasocha B. Ineffective endovascular treatment of a giant internal carotid artery aneurysm. Pol J Radiol. 2020 Jun 27;85:e323-e327. doi: 10.5114/pjr.2020.96979. eCollection 2020. PMID: 32685068; PMCID: PMC7361365.
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Pol J Radiol. 2020 Jun 27;85:e323-e327. doi: 10.5114/pjr.2020.96979. eCollection 2020.

Ineffective endovascular treatment of a giant internal carotid artery aneurysm.

Polish journal of radiology

Paweł Brzegowy, Ositadima Chukwu, Katarzyna Ciuk, Andrzej Urbanik, Tadeusz Popiela, Borys Kwinta, Bartłomiej Łasocha

Affiliations

  1. Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland.
  2. Students' Scientific Group at the Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland.
  3. Department of Neurosurgery, Jagiellonian University Medical College, Krakow, Poland.
  4. Department of Imaging Studies, Emergency and Mass-Event Medicine Trauma Centre, University Hospital, Krakow, Poland.

PMID: 32685068 PMCID: PMC7361365 DOI: 10.5114/pjr.2020.96979

Abstract

PURPOSE: Despite a growing range of therapeutic possibilities, including various intravascular methods, treating cerebral aneurysms can be still a therapeutic challenge. A growing number of patients previously treated with older techniques require additional therapy. Treatment options as well as their efficiency may be influenced by previous procedures.

CASE REPORT: We report a rare case of a giant treatment-resistant aneurysm in a 65-year-old woman. The aneurysm was first diagnosed due to visual disturbances in the right eye. Computed tomography angiography showed large (20 × 18 mm) wide neck aneurysm of the right internal carotid artery. The patient was subsequently treated with several methods including coiling with regular stent implantation, two flow diverter stent implantations, and hybrid neurosurgery. Full occlusion was not achieved after any of those procedures. After the last procedure (hybrid neurosurgery) the patient, in vegetative state, was transferred to the intensive care unit and then to the Health and Care Centre.

CONCLUSIONS: Discussion focuses on endovascular treatment options after failure of previous treatment such as "stent in stent" technique. We conclude that three subsequent stent implantations are technically possible; however, subsequent procedures are associated with technical difficulties and their effectiveness is questionable. Ventriculoperitoneal shunt may influence the outcome of flow diversion therapy.

Copyright © Polish Medical Society of Radiology 2020.

Keywords: endovascular treatment; flow diverter; intracranial aneurysm; stent-in-stent technique

Conflict of interest statement

The authors declare no conflict of interest.

References

  1. J Neurosurg. 2017 Feb;126(2):578-585 - PubMed
  2. AJNR Am J Neuroradiol. 2015 Jun;36(6):E53 - PubMed
  3. BMJ Case Rep. 2016 Jul 19;2016: - PubMed
  4. Mcgill J Med. 2006 Jul;9(2):141-6 - PubMed
  5. Neurochirurgie. 2015 Dec;61(6):361-5 - PubMed
  6. AJNR Am J Neuroradiol. 2017 Nov;38(11):2131-2137 - PubMed
  7. Oper Neurosurg (Hagerstown). 2018 Dec 1;15(6):624-633 - PubMed
  8. J Clin Neurosci. 2012 Jan;19(1):166-70 - PubMed
  9. Neurol Med Chir (Tokyo). 2019 Jan 15;59(1):1-9 - PubMed
  10. Interv Neuroradiol. 2009 Jul 29;15(2):135-44 - PubMed
  11. World Neurosurg. 2016 Sep;93:486.e7-486.e12 - PubMed
  12. Interv Neuroradiol. 2009 Sep;15(3):309-15 - PubMed
  13. J Neurointerv Surg. 2019 Sep;11(9):e5 - PubMed

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