Clipping in Awake Surgery as End-Stage in a Complex Internal Carotid Artery Aneurysm After Failure of Multimodal Endovascular and Extracranial-Intracranial.

Slides:

Advertisements

Similar presentations

Volume 98, Pages 879.e1-879.e4 (February 2017)

Advertisements

Bow Hunter's Syndrome after Contralateral Vertebral Artery Dissection

Jon S. Matsumura, MD, Wesley S. Moore, MD Journal of Vascular Surgery

Pasquale F. Finelli, MD Journal of Stroke and Cerebrovascular Diseases

Volume 92, Pages (August 2016) Posterior Cerebral Artery Aneurysms: Treatment and Outcome Analysis in 121 Patients Felix Goehre, Behnam Rezai.

Effect of contrast material (Levovist) infusion on peak systolic velocity in middle cerebral artery using transcranial color-coded duplex sonography

Celiac artery coverage after occlusion test during endovascular stent grafting for thoracoabdominal aortic aneurysm Taro Shimazaki, MD, Satoshi Kawaguchi,

Tinnitus resulting from tandem lesions of the internal carotid artery: combined extracranial endarterectomy and intrapetrous primary stenting Olivier.

Cerebral hyperperfusion syndrome after endovascular covered stent grafting for a giant extracranial aneurysm of the internal carotid artery Sakyo Hirai,

Lee J. Goldstein, MD, Combiz Rezayat, MD, Gautam V

New routing alternative for proximal anterior tibial artery bypass in patients with Buerger disease Taeseung Lee, MD, PhD, Hwan Do Ra, MD, Yang Jin Park,

Neurofibromatosis-associated massive right internal carotid artery aneurysm with a coexisting arteriovenous fistula Marlin Wayne Causey, MD, Daniel M.

Elisabeth Schwierz, MD, Ralf R

Two-stage carotid saphenous vein interposition graft and superficial temporal artery bypass for acute carotid occlusion Lukas Andereggen, MD, Robert.

Philippe Dion-Cloutier, MD, Donatella Tampieri, MD, FRCPC

Endovascular treatment with flow-diverting stents of symptomatic superior mesenteric artery after dissection aneurysm Giuseppe Baldino, MD, Paolo Mortola,

Two-stage carotid saphenous vein interposition graft and superficial temporal artery bypass for acute carotid occlusion Lukas Andereggen, MD, Robert.

Endovascular treatment of contained rupture of a superior mesenteric artery aneurysm resulting from neurofibromatosis type I Célio Teixeira Mendonça,

S. Schimansky, P.A. Naughton EJVES Extra

Arne Gerhard Schwindt, MD, Giuseppe Panuccio, MD, Konstantinos P

Figure 1 Management of acute ischaemic stroke after ICA-T occlusion

Fourteen-year outcomes of abdominal aortic endovascular repair with the Zenith stent graft Fabio Verzini, MD, PhD, FEBVS, Lydia Romano, MD, Gianbattista.

Endovascular repair of tortuous recurrent femoral-popliteal aneurysm in a patient with Loeys-Dietz syndrome Sophie Wang, BS, Amber Kernodle, MD, MPH,

Pipeline Embolization Device for the treatment of cervical carotid and vertebral dissecting aneurysms Emma F. Sczudlo, BS, Carolina Benavides-Baron,

R. George, S. Przybojewski, S. Theron EJVES Extra

Management of a rapidly expanding celiac artery aneurysm with the chimney technique Andreia Coelho, MD, Pedro Monteiro, MD, Clara Nogueira, MD, Ricardo.

The feasibility of endovascular aortic repair strategy in treating infected aortic aneurysms Chung-Dann Kan, MD, PhD, Hsu-Ting Yen, MD, Chung-Ben Kan,

Transcranial Doppler-guided selective antegrade cerebral perfusion during aortic debranching operation Ali Khoynezhad, MD, FACC, FACP, Rolando Celis,

Coil embolization of bilateral internal mammary artery aneurysms is durable in a patient with Marfan syndrome Toshiki Fujiyoshi, MD, Toshiya Nishibe,

Advantage of a precurved fenestrated endograft for aortic arch disease: Simplified arch aneurysm treatment in Japan 2010 and 2011 Yoshihiko Yokoi, MD,

Surgical management after stent-graft failure during the frozen elephant trunk technique for acute type A aortic dissection Maximilian Luehr, MD, Christian.

Efficacy and durability of the chimney graft technique in urgent and complex thoracic endovascular aortic repair Adel Bin Jabr, MD, Bengt Lindblad, MD,

Endovascular repair of an iliac artery aneurysm in a patient with Ehlers-Danlos syndrome type IV Britt H. Tonnessen, MD, W. Charles Sternbergh, MD, Krishna.

Preemptive Aneurysm Sac Embolization for Thoracic Endovascular Aortic Repair With Inadequate Proximal Landing Zone Jacky Y.K. Ho, MRCS, Randolph H.L.

Endovascular repair of a celiac trunk aneurysm with a new multilayer stent Giampaolo Carrafiello, MD, Nicola Rivolta, MD, Matteo Annoni, MD, Federico.

Jonathan J. Sexton, MD, David R. Whittaker, MD

Elisabeth Schwierz, MD, Ralf R

Giant vein graft pseudoaneurysm with pulmonary hemorrhage

Vladimir Neychev, MD, PhD, Emilia Krol, MD, Alan Dietzek, MD

New routing alternative for proximal anterior tibial artery bypass in patients with Buerger disease Taeseung Lee, MD, PhD, Hwan Do Ra, MD, Yang Jin Park,

Endovascular treatment of ruptured axillary and large internal mammary artery aneurysms in a patient with Marfan syndrome Jessica F. Rose, DO, Layla.

Jon S. Matsumura, MD, Wesley S. Moore, MD Journal of Vascular Surgery

Management of a nontraumatic extracranial internal carotid aneurysm with external carotid transposition W. Tracey Jones, MD, Jerry Pratt, MD, James Connaughton,

Use of a surgeon-modified branched thoracic endograft to preserve an aortorenal bypass during treatment of an intercostal patch aneurysm Jeffrey Jim,

Hybrid Endovascular Exclusion of a Bleeding Innominate Artery Pseudoaneurysm in a Patient With No Open Surgical Options Asad J. Choudhry, MBBS, Palma.

Sideways displacement of the endograft within the aneurysm sac is associated with late adverse events after endovascular aneurysm repair Evert J. Waasdorp,

Ruptured Thoracoabdominal Aneurysm Treatment With Modified Chimney Stent Graft Mario Marino, MD, Holta Kasemi, MD, Costantino Luca Di Angelo, MD, Gian.

Endovascular treatment of right-sided subclavian artery aneurysm in a congenitally malformed aortic arch Gabriele Iannelli, MD, Luigi Di Tommaso, MD,

Severe visceral ischemia and death after multilayer stent deployment for the treatment of a thoracoabdominal aortic aneurysm Rafael Noronha Cavalcante,

Jae Woong Lim, MD, Chang Woo Choi, MD, Keun Her, MD, Hwa Kyun Shin, MD

Supra-aortic hybrid endovascular procedures for complex thoracic aortic disease: Single center early to midterm results Yiu Che Chan, BSc MB, BS, MD,

C. Y. Maximilian Png, BA, James W. Cornwall, MD, Peter L

Combined endovascular and open operative approach for mycotic carotid aneurysm Thomas C. Tsai, AB, Nikhil Barot, MD, Ronald Dalman, MD, Frederick Mihm,

Sybren M. M. Robijn, Jantien C. Welleweerd, MD, Rob T. H

Management of endograft infection coupled with aortoesophageal fistula: Extra- anatomic aortic bypass and endograft explantation Mariangela De Masi, MD,

Late renal artery stent fracture with pseudoaneurysm after fenestrated endovascular abdominal aortic aneurysm repair Shanil M. Yapa, MSc, MBBS, Kishore.

Endoleaks after endovascular graft treatment of aortic aneurysms: Classification, risk factors, and outcome Reese A. Wain, MD, Michael L. Marin, MD,

Contralateral hyperacute intracerebral hemorrhage after carotid artery stenting with contralateral internal carotid artery occlusion Hirokazu Takami,

Concomitant asymptomatic internal carotid artery and persistent primitive hypoglossal artery stenosis treated by endovascular stenting with proximal embolic.

Sybren M. M. Robijn, Jantien C. Welleweerd, MD, Rob T. H

Shelby Kutty, MD, Roy K. Greenberg, MD, Scott Fletcher, MD, Lars G

Type B aortic dissection after endovascular abdominal aortic aneurysm repair causing endograft collapse and severe malperfusion Vikram Iyer, MD, Mark.

Endovascular repair of a Kommerell's diverticulum in a patient with a left-sided aortic arch and right-sided descending thoracic aorta Paul J. Riesenman,

Endovascular treatment of arch and proximal thoracic aortic lesions

Hybrid Repair of an Aortic Arch Aneurysm Using Double Parallel Grafts Perfused by Retrograde Flow in Endovascular Repair Combined With Left Subclavian.

Successful endovascular treatment of hemosuccus pancreaticus due to splenic artery aneurysm associated with segmental arterial mediolysis Hideaki Obara,

Complete regression of a symptomatic, mycotic juxtarenal abdominal aortic aneurysm after treatment with fenestrated endovascular aneurysm repair Jonathan.

Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta Gabriele Piffaretti, MD, PhD, Mario Galli, MD, Chiara Lomazzi, MD,

Postoperative Coronary Aneurysm Treated With Endovascular Coiling

Percutaneous fenestrated endovascular aortic graft treatment of aortocaval fistula with aortic pseudoaneurysms secondary to penetrating trauma Sheila.

Presentation transcript:

Clipping in Awake Surgery as End-Stage in a Complex Internal Carotid Artery Aneurysm After Failure of Multimodal Endovascular and Extracranial-Intracranial Bypass Treatment Delia Cannizzaro, MD, Simone Peschillo, MD, PhD, Cristina Mancarella, MD, Biagia La Pira, MD, Emanuela Rastelli, MD, Emiliano Passacantilli, MD, PhD, Antonio Santoro, MD, PhD Journal of Stroke and Cerebrovascular Diseases Volume 26, Issue 6, Pages e114-e118 (June 2017) DOI: 10.1016/j.jstrokecerebrovasdis.2017.03.028 Copyright © 2017 National Stroke Association Terms and Conditions

Figure 1 Computed tomography scan: subarachnoid hemorrhage of the basal cisterns (A). Angio-CT scan shows a large aneurysm of the left internal carotid artery on axial (B) and coronal (C) views. Journal of Stroke and Cerebrovascular Diseases 2017 26, e114-e118DOI: (10.1016/j.jstrokecerebrovasdis.2017.03.028) Copyright © 2017 National Stroke Association Terms and Conditions

Figure 2 Coiling of the internal carotid artery aneurysm in lateral (A) and anterior (B) projection. The patient underwent coiling procedure with a subtotal occlusion due to the large aneurysm neck: it was decided to re-treat the aneurysm with a flow diverter stent within 3 months. Journal of Stroke and Cerebrovascular Diseases 2017 26, e114-e118DOI: (10.1016/j.jstrokecerebrovasdis.2017.03.028) Copyright © 2017 National Stroke Association Terms and Conditions

Figure 3 Prestenting of the internal carotid artery aneurysm in anterior projection showed a big recurrence (A). Three-dimensional reconstruction shows where the stent was deployed (from left middle cerebral artery to left internal carotid artery aneurysm) (B). Journal of Stroke and Cerebrovascular Diseases 2017 26, e114-e118DOI: (10.1016/j.jstrokecerebrovasdis.2017.03.028) Copyright © 2017 National Stroke Association Terms and Conditions

Figure 4 A 1-month middle cerebral artery follow-up showed a steady state of aneurysm size (A). A 3-month MRA follow-up showed an increase in aneurysm size (B and C). Journal of Stroke and Cerebrovascular Diseases 2017 26, e114-e118DOI: (10.1016/j.jstrokecerebrovasdis.2017.03.028) Copyright © 2017 National Stroke Association Terms and Conditions

Figure 5 The picture shows the extra-intracranial bypass between external carotid artery and left middle cerebral artery. In (A), the venous graft is lean on the distal segment of left middle cerebral artery. In (B), handmade suture is showed. MCA, middle cerebral artery. Journal of Stroke and Cerebrovascular Diseases 2017 26, e114-e118DOI: (10.1016/j.jstrokecerebrovasdis.2017.03.028) Copyright © 2017 National Stroke Association Terms and Conditions

Figure 6 Digital subtraction angiography (anterior projection) showed the occlusion of the aneurysm and the patency and the regular course of the graft. Journal of Stroke and Cerebrovascular Diseases 2017 26, e114-e118DOI: (10.1016/j.jstrokecerebrovasdis.2017.03.028) Copyright © 2017 National Stroke Association Terms and Conditions

Figure 7 Digital subtraction angiography (anterior projection) showed a new portion of the sac with the persistence patency of the graft. Journal of Stroke and Cerebrovascular Diseases 2017 26, e114-e118DOI: (10.1016/j.jstrokecerebrovasdis.2017.03.028) Copyright © 2017 National Stroke Association Terms and Conditions

Figure 8 The midterm DSA (anterior [A] and oblique [B] projection) showed the occlusion of the aneurysm and the patency and regular course of the graft. In red, the schematic of the clip. (Color version of figure is available online.) Journal of Stroke and Cerebrovascular Diseases 2017 26, e114-e118DOI: (10.1016/j.jstrokecerebrovasdis.2017.03.028) Copyright © 2017 National Stroke Association Terms and Conditions