Ting W, Richard SA, Changwei Z, Chaohua W, Xiaodong X. Delayed spontaneous rupture of cavernous segment of the internal carotid artery following dual
ophthalmic segment aneurysms treatment with pipeline embolization device: A case report.
Medicine (Baltimore) 2019;
98:e18420. [PMID:
31876716 PMCID:
PMC6946193 DOI:
10.1097/md.0000000000018420]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/31/2019] [Accepted: 11/14/2019] [Indexed: 11/29/2022] Open
Abstract
RATIONALE
The incidence of double aneurysms on the ophthalmic segment of the internal carotid artery (ICA) is very rare. Nevertheless, delayed rupture of a parent artery instead of the aneurysmal sac following pipeline embolization device (PLED) is unusual.
PATIENT CONCERNS
We present a 72-year-old female who was admitted at our facility with gradual onset of nonspecific visual changes.
DIAGNOSIS
Conventional angiography revealed 2 aneurysms located at the ophthalmic segment of the left ICA.
INTERVENTIONS
Both aneurysms were successfully treated with PLED.
OUTCOMES
Two months after discharge, the patient was rushed into the emergency with bilateral conjunctival congestion. Computed tomography revealed intracranial hemorrhage at left temporal lobe while digital subtraction angiography established a left direct carotid cavernous fistula. We utilized stent (Solitaire 6*30) assisted coils to occlude the fistula. The patient is well and go about her normal duties.
LESSIONS
Manipulation of the tortuous parent artery resulted in a focal traumatic weakness in the artery and subsequently a delay tear. We are of the view that, endovascular surgeons should be on the lookout for this complication following flow deviation treatment modalities.
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