Concurrent Carotid Endarterectomy and Flow Diverting for Supraclinoid Artery Aneurysm

The patient had undergone computed tomography (CT) cerebral imaging following coronary artery bypass grafting 8 years previously which demonstrated an incidental right-sided, wide-necked, supraclinoid ICA aneurysm measuring approximately 11 mm and right ICA stenosis of 60% by North American Symptoma...

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Bibliographic Details
Published in:Canadian journal of neurological sciences 2022-01, Vol.49 (1), p.146-148
Main Authors: Kiwan, Ruba, Jukes, Alistair, Johnston, Burnett, Boulton, Melfort
Format: Article
Language:English
Subjects:
Aneurysms
Arteries
Calcification
Carotid arteries
Carotid Artery Diseases - complications
Carotid Artery Diseases - diagnostic imaging
Carotid Artery Diseases - surgery
Carotid Artery, Internal - diagnostic imaging
Carotid Artery, Internal - surgery
Catheters
Endarterectomy, Carotid
Humans
Intracranial Aneurysm - complications
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - surgery
Letters to the Editor: Published Article
Neck
Stents
Veins & arteries
Citations: Items that this one cites
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Summary:The patient had undergone computed tomography (CT) cerebral imaging following coronary artery bypass grafting 8 years previously which demonstrated an incidental right-sided, wide-necked, supraclinoid ICA aneurysm measuring approximately 11 mm and right ICA stenosis of 60% by North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria at the carotid bifurcation in the neck at that time. The decision was also made to treat the carotid stenosis via a carotid endarterectomy to both reduce the ongoing risk of stroke and concern that accessing the aneurysm for placement of a flow diverter would be impeded by the degree of stenosis. Flow diversion for wide-necked, supraclinoid aneurysms is a widely practiced and published technique with excellent outcomes reported.3,4 The technique of direct carotid puncture to place access sheath and guide catheters has previously been reported due to excessive common carotid or ICA tortuosity.5,6 To our knowledge, this is the first described instance of concurrent endarterectomy to provide access for deployment of flow diverting stent.
ISSN:0317-1671
2057-0155
DOI:10.1017/cjn.2021.48