Successful treatment of iatrogenic internal carotid artery pseudoaneurysm following carotid endarterectomy with thrombin injection: a case report.

Autor: Jiang C; Department of Neurology, Baotou Central Hospital, No. 61 Huanchenglu, Donghe District, Baotou, 014040, Inner Mongolia, China.; Neurointerventional Medical Center of Inner Mongolia Medical University, Baotou, Inner Mongolia, China.; Neurological Diseases Clinical Medicine Research Center, Baotou, Inner Mongolia, China., Liu J; Department of Neurology, Baotou Central Hospital, No. 61 Huanchenglu, Donghe District, Baotou, 014040, Inner Mongolia, China.; Neurointerventional Medical Center of Inner Mongolia Medical University, Baotou, Inner Mongolia, China.; Neurological Diseases Clinical Medicine Research Center, Baotou, Inner Mongolia, China., Zhuo N; Inner Mongolia Medical University, Hohhot, Inner Mongolia, China., Wei J; Inner Mongolia Medical University, Hohhot, Inner Mongolia, China., Fan Y; Department of Neurology, Baotou Central Hospital, No. 61 Huanchenglu, Donghe District, Baotou, 014040, Inner Mongolia, China. 13654729916@163.com.; Neurointerventional Medical Center of Inner Mongolia Medical University, Baotou, Inner Mongolia, China. 13654729916@163.com.; Neurological Diseases Clinical Medicine Research Center, Baotou, Inner Mongolia, China. 13654729916@163.com.
Jazyk: angličtina
Zdroj: Journal of medical case reports [J Med Case Rep] 2024 Jun 18; Vol. 18 (1), pp. 282. Date of Electronic Publication: 2024 Jun 18.
DOI: 10.1186/s13256-024-04606-z
Abstrakt: Background: Iatrogenic pseudoaneurysms arising from the internal carotid artery subsequent to carotid endarterectomy are exceptionally infrequent. Herein, we present a case detailing an internal carotid artery pseudoaneurysm that manifested subsequent to a hybrid carotid endarterectomy and endovascular therapy intervention. Our approach to managing this condition involved a novel technique wherein thrombin was directly injected into the luminal cavity of the pseudoaneurysm under the guidance of a C-arm.
Case Presentation: A 66-year-old male patient of Chinese ethnicity exhibited a 4-month history of headache and a 20-day history of gait disturbance. Digital subtraction angiography revealed occlusion in the cervical region of the left carotid artery. Following a hybrid surgical procedure, the patient reported mild pain and bruising surrounding the incision site of the left internal carotid artery endarterectomy. Subsequent angiography identified the presence of a carotid artery pseudoaneurysm. Utilizing C-arm guidance, thrombin was then directly injected into the luminal cavity of the pseudoaneurysm, resulting in complete healing during follow-up.
Conclusion: For the management of pseudoaneurysms arising post carotid endarterectomy, the direct injection of thrombin into the aneurysm cavity under the guidance of a C-arm is deemed both safe and efficacious.
(© 2024. The Author(s).)
Databáze: MEDLINE
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