Endovascular Treatment of Carotid Artery Aneurysms With Covered Stents
A 64-year-old man with pulsatile neck mass was referred for evaluation. His past medical history was significant for neck cancer in 1985, which was treated with surgery and radiation. He developed symptomatic right internal and common carotid artery stenoses in 1998 and underwent carotid stenting, because he was not deemed a surgical candidate due to prior neck surgery and radiation. A duplex ultrasound evaluation of the pulsatile mass revealed aneurysmal dilatation of the carotid artery. Carotid angiography revealed an aneurysm involving the distal right common carotid artery and proximal internal carotid artery (Figure, left). Prior neck surgery and radiation precluded surgical correction, so the patient underwent successful implantation of 2 overlapping Wallgrafts (Boston Scientific) to seal the aneurysm. Because the external carotid artery came off from the aneurysmal area, it was closed with 0.014-inch Vortex coils (Boston Scientific, Target Therapeutics,) to prevent retrograde filling of the aneurysm (Figure, right).
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
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