Endovascular Treatment of Common Carotid Artery Giant Aneurysm Using Intrasaccular Deployment Technique of Vascular Plug

This case report describes a giant proximal common carotid artery aneurysm with partial thrombosis, which was treated by applying an Amplatzer vascular plug II (AVP II) for intrasaccular deployment and landing in the limited inflow zone. Endovascular embolization was suggested because of the high risk of open surgery and the difficulties of stenting. The patient passed the balloon occlusion test, and we attempted endovascular sacrifice of the carotid artery. The high flow status and limited inflow zone render such sacrificing challenging. Based on our experience in treating intracranial aneurysms, we used flow disruption intrasaccular Woven EndoBridge (WEB) to achieve embolization. The AVP II was designed similarly to the WEB device. We applied the same concept by deploying the AVP II intrasaccularly and landed in the aneurysm inflow zone. For a giant aneurysm with high flow and a limited landing zone, the AVP II can be deployed intrasaccularly by using a compressing technique to achieve complete occlusion of both the aneurysmal sac and the proximal inflow landing zone, thus preventing recanalization and endoleak.

關鍵字

common carotid artery ； aneurysm ； endovascular treatment ； vascular plug ； intrasaccular

參考文獻

Welleweerd JC, den Ruijter HM, Nelissen BG, et al. Management of extracranial carotid artery aneurysm. Eur J Vasc Endovasc Surg. 2015 Aug; 50(2):141-7.

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Wang W, Li H, Tam MD, et al. The amplatzer vascular plug: a review of the device and its clinical applications. Cardiovasc Intervent Radiol. 2012 Aug;35(4):725-40.

Arthur AS, Molyneux A, Coon AL, et al. The safety and effectiveness of the Woven EndoBridge (WEB) system for the treatment of wide-necked bifurcation aneurysms: final 12-month results of the pivotal WEB Intrasaccular Therapy (WEB-IT) Study. J Neurointerv Surg. 2019 Sep;11(9):924-930.

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延伸閱讀

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國際替代計量

Endovascular Treatment of Common Carotid Artery Giant Aneurysm Using Intrasaccular Deployment Technique of Vascular Plug

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