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- Publisher Website: 10.1136/neurintsurg-2014-011154
- Scopus: eid_2-s2.0-84937717919
- PMID: 24852405
- WOS: WOS:000358261100014
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Article: Primary endovascular treatment of post-irradiated carotid pseudoaneurysm at the skull base with the Pipeline embolization device
Title | Primary endovascular treatment of post-irradiated carotid pseudoaneurysm at the skull base with the Pipeline embolization device |
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Authors | |
Issue Date | 2015 |
Publisher | BMJ 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? |
Abstract | Background 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 Identifier | http://hdl.handle.net/10722/198113 |
ISSN | 2023 Impact Factor: 4.5 2023 SCImago Journal Rankings: 1.659 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Tsang, ACO | - |
dc.contributor.author | Lui, WM | - |
dc.contributor.author | Leung, GKK | - |
dc.date.accessioned | 2014-06-25T02:47:31Z | - |
dc.date.available | 2014-06-25T02:47:31Z | - |
dc.date.issued | 2015 | - |
dc.identifier.citation | Journal of NeuroInterventional Surgery, 2015, v. 7 n. 8, p. 603-607 | - |
dc.identifier.issn | 1759-8478 | - |
dc.identifier.uri | http://hdl.handle.net/10722/198113 | - |
dc.description.abstract | Background 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.language | eng | - |
dc.publisher | BMJ Group. The Journal's web site is located at http://jnis.bmj.com | - |
dc.relation.ispartof | Journal of NeuroInterventional Surgery | - |
dc.rights | Journal of NeuroInterventional Surgery. Copyright © BMJ Group. | - |
dc.rights | This 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.title | Primary endovascular treatment of post-irradiated carotid pseudoaneurysm at the skull base with the Pipeline embolization device | - |
dc.type | Article | - |
dc.identifier.email | Tsang, COA: acotsang@hku.hk | - |
dc.identifier.email | Lui, WM: mattlui@hku.hk | - |
dc.identifier.email | Leung, GKK: gilberto@hku.hk | - |
dc.identifier.authority | Tsang, COA=rp01519 | - |
dc.identifier.authority | Leung, GKK=rp00522 | - |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1136/neurintsurg-2014-011154 | - |
dc.identifier.pmid | 24852405 | - |
dc.identifier.scopus | eid_2-s2.0-84937717919 | - |
dc.identifier.hkuros | 229427 | - |
dc.identifier.volume | 7 | en_US |
dc.identifier.spage | 1 | en_US |
dc.identifier.epage | 5 | en_US |
dc.identifier.isi | WOS:000358261100014 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 1759-8478 | - |