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Article: Primary endovascular treatment of post-irradiated carotid pseudoaneurysm at the skull base with the Pipeline embolization device

TitlePrimary endovascular treatment of post-irradiated carotid pseudoaneurysm at the skull base with the Pipeline embolization device
Authors
Issue Date2015
PublisherBMJ Group. The Journal's web site is located at http://jnis.bmj.com
Citation
Journal of NeuroInterventional Surgery, 2015, v. 7 n. 8, p. 603-607 How to Cite?
AbstractBackground A post-irradiated carotid pseudoaneurysm at the skull base can cause life-threatening blowout syndrome. Conventional treatments include parent vessel occlusion, endovascular coiling or covered stenting. Use of the Pipeline embolization device (PED) for pseudoaneurysm exclusion at the skull base is not well described. Objective To report the clinical and angiographic outcome after using multiple PEDs to treat recently ruptured radiation-induced carotid pseudoaneurysms at the skull base. Methods Retrospective review of the clinical and angiographic records of patients who received PEDs as primary treatment for skull base carotid pseudoaneurysm between April 1, 2011 to March 31, 2013. Results Seven patients (five men, two women) with a mean age of 58 years (range 47–65) were treated in the study period. Primary treatment with the PED alone, with adjunct coil embolization in two patients, achieved immediate hemostasis in all patients, with no pseudoaneurysm rebleeding after a mean follow-up of 15.3 months (range 4–24 months). One patient had periprocedural cerebral infarction. Delayed internal carotid artery occlusion secondary to in-stent thrombosis occurred in three patients, one of whom had lacunar infarct and two remained asymptomatic. Conclusions Endovascular treatment with the PED was effective in excluding skull base post-irradiated carotid pseudoaneurysms and preventing recurrent blowout. However, the risk of ischemic complications in this group of patients was high and our experience did not support the use of flow diverters as a first-line treatment for this condition.
Persistent Identifierhttp://hdl.handle.net/10722/198113
ISSN
2015 Impact Factor: 2.959
2015 SCImago Journal Rankings: 0.932

 

DC FieldValueLanguage
dc.contributor.authorTsang, ACO-
dc.contributor.authorLui, WM-
dc.contributor.authorLeung, GKK-
dc.date.accessioned2014-06-25T02:47:31Z-
dc.date.available2014-06-25T02:47:31Z-
dc.date.issued2015-
dc.identifier.citationJournal of NeuroInterventional Surgery, 2015, v. 7 n. 8, p. 603-607-
dc.identifier.issn1759-8478-
dc.identifier.urihttp://hdl.handle.net/10722/198113-
dc.description.abstractBackground A post-irradiated carotid pseudoaneurysm at the skull base can cause life-threatening blowout syndrome. Conventional treatments include parent vessel occlusion, endovascular coiling or covered stenting. Use of the Pipeline embolization device (PED) for pseudoaneurysm exclusion at the skull base is not well described. Objective To report the clinical and angiographic outcome after using multiple PEDs to treat recently ruptured radiation-induced carotid pseudoaneurysms at the skull base. Methods Retrospective review of the clinical and angiographic records of patients who received PEDs as primary treatment for skull base carotid pseudoaneurysm between April 1, 2011 to March 31, 2013. Results Seven patients (five men, two women) with a mean age of 58 years (range 47–65) were treated in the study period. Primary treatment with the PED alone, with adjunct coil embolization in two patients, achieved immediate hemostasis in all patients, with no pseudoaneurysm rebleeding after a mean follow-up of 15.3 months (range 4–24 months). One patient had periprocedural cerebral infarction. Delayed internal carotid artery occlusion secondary to in-stent thrombosis occurred in three patients, one of whom had lacunar infarct and two remained asymptomatic. Conclusions Endovascular treatment with the PED was effective in excluding skull base post-irradiated carotid pseudoaneurysms and preventing recurrent blowout. However, the risk of ischemic complications in this group of patients was high and our experience did not support the use of flow diverters as a first-line treatment for this condition.-
dc.languageeng-
dc.publisherBMJ Group. The Journal's web site is located at http://jnis.bmj.com-
dc.relation.ispartofJournal of NeuroInterventional Surgery-
dc.rightsJournal of NeuroInterventional Surgery. Copyright © BMJ Group.-
dc.rightsThis article has been accepted for publication in JNIS following peer review. The definitive copyedited, typeset version Journal of NeuroInterventional Surgery, 2015, v. 7 n. 8, p. 603-607, is available online at: http://jnis.bmj.com/content/early/2014/05/22/neurintsurg-2014-011154-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titlePrimary endovascular treatment of post-irradiated carotid pseudoaneurysm at the skull base with the Pipeline embolization device-
dc.typeArticle-
dc.identifier.emailTsang, COA: acotsang@hku.hk-
dc.identifier.emailLui, WM: mattlui@hku.hk-
dc.identifier.emailLeung, GKK: gilberto@hku.hk-
dc.identifier.authorityTsang, COA=rp01519-
dc.identifier.authorityLeung, GKK=rp00522-
dc.description.naturepostprint-
dc.identifier.doi10.1136/neurintsurg-2014-011154-
dc.identifier.pmid24852405-
dc.identifier.hkuros229427-
dc.identifier.volume7en_US
dc.identifier.spage1en_US
dc.identifier.epage5en_US
dc.publisher.placeUnited Kingdom-

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