PMC3551517_01
(a) Postoperative CT angiogram (CTA) showed no evidence of contrast extravasation or pseudoaneurysm. (b) A CTA repeated one week later, revealed a 2x1.4 mm pseudoaneurysm arising from the left internal carotid artery at the level of the carotid canal dehiscence
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F1
The patient awoke neurologically intact and an immediate postoperative computed tomography angiogram (CTA) showed no evidence of contrast extravasation or pseudoaneurysm [Figure 1a]. A CTA repeated one week later, revealed a 2 x 1.4 mm pseudoaneurysm arising from the left internal carotid artery at the level of the carotid canal dehiscence [Figure 1b].
(a) Angiography demonstrating traumatic pseudoaneurysm. (b) Angiogram demonstrates demonstrating balloon occlusion (6x9 mm), which the patient passed with hypotensive challenge
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F2
Angiography confirmed the presence of the pseudoaneurysm, [Figure 2a] and she passed a test balloon occlusion with hypotensive challenge [Figure 2b].
(a) At the time of treatment, the pseudoaneurysm had enlarged to 2.8 mm. (b) A 4x16 mm Pipeline stent was deployed across the pseudoaneurysm and the control angiogram demonstrated contrast stasis within the aneurysmal dome. (c) A 4x14 mm Pipeline stent was placed within the first stent to reinforce the construct and the final control angiogram revealed further stasis
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F3
At the time of treatment, the pseudoaneurysm had enlarged to 2.8 mm [Figure 3a]. A 4 x 16 mm Pipeline stent was deployed across the pseudoaneurysm and the control angiogram demonstrated contrast stasis within the aneurysmal dome [Figure 3b]. A 4 x 14 mm Pipeline stent was placed within the first stent to reinforce the construct and the final control angiogram revealed further stasis [Figure 3c].
Angiogram at 4-month follow-up showed complete obliteration of the pseudoaneurysm and successful reconstruction of the left internal carotid lumen
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F4
Four-month follow-up angiogram showed complete obliteration of the pseudoaneurysm and successful reconstruction of the left internal carotid lumen [Figure 4].