Transcarotid stenting of extracranial carotid artery aneurysm with covered stents and flow reversal
Introduction: An extracranial carotid artery aneurysm (ECAA) is a rare pathology comprising <1% of all arterial aneurysms. The etiology includes trauma, previous surgery, radiation, and infection. Treatment of ECAAs has evolved from open repair to endovascular repair with stenting. Reports of end...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Journal of Vascular Surgery Cases and Innovative Techniques |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468428723002563 |
| _version_ | 1797385225877061632 |
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| author | S. Taha Zaidi, DO Mitchell J. George, MD Tommaso Cambiaghi, MD Naveed Saqib, MD Daniel Miles, MD Shihuan Wang, MD Stuart Harlin, MD |
| author_facet | S. Taha Zaidi, DO Mitchell J. George, MD Tommaso Cambiaghi, MD Naveed Saqib, MD Daniel Miles, MD Shihuan Wang, MD Stuart Harlin, MD |
| author_sort | S. Taha Zaidi, DO |
| collection | DOAJ |
| description | Introduction: An extracranial carotid artery aneurysm (ECAA) is a rare pathology comprising <1% of all arterial aneurysms. The etiology includes trauma, previous surgery, radiation, and infection. Treatment of ECAAs has evolved from open repair to endovascular repair with stenting. Reports of endovascular repair describe the transfemoral approach; however, little more than case reports are available describing the transcarotid approach for ECAAs. In this study, we describe a cohort of patients who safely underwent transcarotid repair of ECAAs. Methods: We performed a retrospective medical record review of all cases of transcarotid stenting using covered stents for a carotid aneurysm within 11 different hospitals within the Memorial Hermann Health System from December 2019 through December 2022. Technical success is defined as coverage of the aneurysm with no endoleak. We report the patient demographics, clinical presentation, intraoperative metrics, and outcomes. Results: Seven patients underwent transcarotid covered stent placement using flow reversal for neurologic protection. Their average age was 65 years, and four of the seven patients were men. Three patients presented with pain, two with transient ischemic attack, one with stroke, and one with a pulsatile mass. Technical success was 100%. All the patients were treated with transcarotid stenting, and the average aneurysm size was 13 mm. The average operative time was 69 minutes, and the flow reversal time was 9 minutes. No postoperative stroke, myocardial infarction, or death occurred. The average length of hospital stay was 2.7 days. Conclusions: A transcarotid approach for endovascular treatment of ECAAs was safe for this cohort of patients, with no postoperative death, stroke, or myocardial infarction. Also, the technical success was 100%. |
| first_indexed | 2024-03-08T21:51:06Z |
| format | Article |
| id | doaj.art-8c04700c52ea4a5484e5bf6ef704a22d |
| institution | Directory Open Access Journal |
| issn | 2468-4287 |
| language | English |
| last_indexed | 2024-03-08T21:51:06Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Vascular Surgery Cases and Innovative Techniques |
| spelling | doaj.art-8c04700c52ea4a5484e5bf6ef704a22d2023-12-20T07:35:20ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872023-12-0194101347Transcarotid stenting of extracranial carotid artery aneurysm with covered stents and flow reversalS. Taha Zaidi, DO0Mitchell J. George, MD1Tommaso Cambiaghi, MD2Naveed Saqib, MD3Daniel Miles, MD4Shihuan Wang, MD5Stuart Harlin, MD6Correspondence: Syed Taha Zaidi, DO, Division of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, 6400 Fannin St, Ste 2850, Houston, TX 77030; Division of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TXDivision of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TXDivision of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TXDivision of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TXDivision of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TXDivision of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TXDivision of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TXIntroduction: An extracranial carotid artery aneurysm (ECAA) is a rare pathology comprising <1% of all arterial aneurysms. The etiology includes trauma, previous surgery, radiation, and infection. Treatment of ECAAs has evolved from open repair to endovascular repair with stenting. Reports of endovascular repair describe the transfemoral approach; however, little more than case reports are available describing the transcarotid approach for ECAAs. In this study, we describe a cohort of patients who safely underwent transcarotid repair of ECAAs. Methods: We performed a retrospective medical record review of all cases of transcarotid stenting using covered stents for a carotid aneurysm within 11 different hospitals within the Memorial Hermann Health System from December 2019 through December 2022. Technical success is defined as coverage of the aneurysm with no endoleak. We report the patient demographics, clinical presentation, intraoperative metrics, and outcomes. Results: Seven patients underwent transcarotid covered stent placement using flow reversal for neurologic protection. Their average age was 65 years, and four of the seven patients were men. Three patients presented with pain, two with transient ischemic attack, one with stroke, and one with a pulsatile mass. Technical success was 100%. All the patients were treated with transcarotid stenting, and the average aneurysm size was 13 mm. The average operative time was 69 minutes, and the flow reversal time was 9 minutes. No postoperative stroke, myocardial infarction, or death occurred. The average length of hospital stay was 2.7 days. Conclusions: A transcarotid approach for endovascular treatment of ECAAs was safe for this cohort of patients, with no postoperative death, stroke, or myocardial infarction. Also, the technical success was 100%.http://www.sciencedirect.com/science/article/pii/S2468428723002563Extracranial carotid artery aneurysmInternal carotid artery aneurysmTCARTranscarotid arterial revascularization |
| spellingShingle | S. Taha Zaidi, DO Mitchell J. George, MD Tommaso Cambiaghi, MD Naveed Saqib, MD Daniel Miles, MD Shihuan Wang, MD Stuart Harlin, MD Transcarotid stenting of extracranial carotid artery aneurysm with covered stents and flow reversal Journal of Vascular Surgery Cases and Innovative Techniques Extracranial carotid artery aneurysm Internal carotid artery aneurysm TCAR Transcarotid arterial revascularization |
| title | Transcarotid stenting of extracranial carotid artery aneurysm with covered stents and flow reversal |
| title_full | Transcarotid stenting of extracranial carotid artery aneurysm with covered stents and flow reversal |
| title_fullStr | Transcarotid stenting of extracranial carotid artery aneurysm with covered stents and flow reversal |
| title_full_unstemmed | Transcarotid stenting of extracranial carotid artery aneurysm with covered stents and flow reversal |
| title_short | Transcarotid stenting of extracranial carotid artery aneurysm with covered stents and flow reversal |
| title_sort | transcarotid stenting of extracranial carotid artery aneurysm with covered stents and flow reversal |
| topic | Extracranial carotid artery aneurysm Internal carotid artery aneurysm TCAR Transcarotid arterial revascularization |
| url | http://www.sciencedirect.com/science/article/pii/S2468428723002563 |
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