Endovascular treatment of giant posttraumatic dissecting aneurysm of internal carotid artery (clinical case and literature review)
A. V. Belopasova,
I. A. Sinitsyn,
A. G. Makarova,
E. S. Zasypkina,
M. V. Dreval,
A. O. Chechetkin,
V. L. Shchipakin,
L. A. Dobrynina https://doi.org/10.24412/1683-3295-2025-27-1-84-90
Abstract
Traumatic dissection of the internal carotid artery is often the result of motor vehicle accidents. The growth of intramural hematoma leads to stenosis or occlusion of the vessel, the formation of a dissecting aneurysm. Clinical manifestations of dissection vary from local pain to the development of a transient or persistent neurological deficit. When medical therapy is not effective, surgical or endovascular approaches are indicated.
This article presents a case of successful endovascular treatment of a giant post-traumatic aneurysm of the internal carotid artery. The issues of choosing tactics for managing patients, devices for stenting dissecting aneurysms are discussed.
About the Authors
A. V. Belopasova
Research Center of Neurology
Russian Federation
Russian Federation
Anastasia V. Belopasova.
80 Volokolamskoye Shosse, Moscow 125367
I. A. Sinitsyn
Research Center of Neurology
Russian Federation
Russian Federation
80 Volokolamskoye Shosse, Moscow 125367
A. G. Makarova
Research Center of Neurology
Russian Federation
Russian Federation
80 Volokolamskoye Shosse, Moscow 125367
E. S. Zasypkina
Research Center of Neurology
Russian Federation
Russian Federation
80 Volokolamskoye Shosse, Moscow 125367
M. V. Dreval
Research Center of Neurology
Russian Federation
Russian Federation
80 Volokolamskoye Shosse, Moscow 125367
A. O. Chechetkin
Research Center of Neurology
Russian Federation
Russian Federation
80 Volokolamskoye Shosse, Moscow 125367
V. L. Shchipakin
Research Center of Neurology
Russian Federation
Russian Federation
80 Volokolamskoye Shosse, Moscow 125367
L. A. Dobrynina
Research Center of Neurology
Russian Federation
Russian Federation
80 Volokolamskoye Shosse, Moscow 125367
References
1. Kalashnikova L.A., Dobrynina L.A. Cervical artery dissection: ischemic stroke and other clinical manifestations. Moscow: VAKO, 2013. 208 p. (In Russ.).
2. Rajz G., Simon D., Bakon M. et al. Traumatic carotid artery dissection. Isr Med Assoc J 2009;11(8):507–8.
3. Molacek J., Baxa J., Houdek K. et al. Bilateral post-traumatic carotid dissection as a result of a strangulation injury. Ann Vasc Surg 2010;24(8):1133.e9–11. DOI: 10.1016/j.avsg.2010.02.042
4. Yang S.T., Huang Y.C., Chuang C.C., Hsu P.W. Traumatic internal carotid artery dissection. J Clin Neurosci 2006;13(1):123–8. DOI: 10.1016/j.jocn.2005.02.016
5. Makhlouf F., Scolan V., Detante O. et al. Post-traumatic dissection of the internal carotid artery associated with ipsilateral facial nerve paralysis: diagnostic and forensic issues. J Forensic Leg Med 2013;20(7):867–9. DOI: 10.1016/j.jflm.2013.06.018
6. De Vries E.E., Vonken E.J., Kappelle L.J. et al. Short-term double layer mesh stent patency for emergent or elective carotid artery stenting. Stroke 2019;50(7):1898–901. DOI: 10.1161/STROKEAHA.118.024586
7. Venketasubramanian N., Mundada P., Hegde A.N. et al. Post-traumatic carotid artery dissection begins at the skull base: a case report. Case Rep Neurol 2020;12(Suppl 1):143–8. DOI: 10.1159/000504567
8. Kalashnikova L.A., Gulevskaya T.S., Sakharova A.V. et al. Dissection of the internal carotid and vertebral arteries: morphology, pathophysiology, provoking factors. Vestnik RGMU = Bulletin of RSMU 2019;(5):78–85. DOI: 10.24075/vrgmu.2019.064 (In Russ.).
9. Gubanova M.V. Clinical and laboratory-instrumental signs connective tissue dysplasia in patients with dissection internal carotid and vertebral arteries. Abstract of dis. … cand. med. sci. Moscow, 2018. 28 p. (In Russ.).
10. Makhlouf F., Scolan V., Detante O. et al. Post-traumatic dissection of the internal carotid artery associated with ipsilateral facial nerve paralysis: diagnostic and forensic issues. J Forensic Leg Med 2013;20(7):867–9. DOI: 10.1016/j.jflm.2013.06.018
11. Norris J.W., Beletsky V., Nadareishvili Z.G. Sudden neck movement and cervical artery dissection. The Canadian Stroke Consortium. CMAJ 2000;163(1):38–40.
12. Caplan L.R. Dissections of brain-supplying arteries. Nat Clin Pract Neurol 2008;4(1):34–42. DOI: 10.1038/ncpneuro0683
13. Blum C.A., Yaghi S. Cervical artery dissection: a review of the epidemiology, pathophysiology, treatment, and outcome. Arch Neurosci 2015;2(4):e26670. DOI: 10.5812/archneurosci.26670
14. Kalashnikova L.A., Dobrynina L.A., Maksimova M.Y. et al. Dissection of the internal carotid and vertebral arteries: tactics of patient management. Ann Clin Exp Neurol 2021;15(1):5–12. DOI: 10.25692/ACEN.2021.1.1
15. Larsson S.C., King A., Madigan J. et al. Prognosis of carotid dissecting aneurysms: results from CADISS and a systematic review. Neurology 2017;88(7):646–52. DOI: 10.1212/WNL.0000000000003617
16. Debette S., Leys D. Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol 2009;8(7):668–78. DOI: 10.1016/S1474-4422(09)70084-5
17. Daou B., Hammer C., Chalouhi N. et al. Dissecting pseudoaneurysms: predictors of symptom occurrence, enlargement, clinical outcome, and treatment. J Neurosurg 2016;125(4):936–42. DOI: 10.3171/2015.10.JNS151846
18. Paraskevas K., Batchelder A.J., Naylor A.R. Fate of distal false aneurysms complicating internal carotid artery dissection: a systematic review. Eur J Vasc Endovasc Surg 2016;52(3):281–6. DOI: 10.1016/j.ejvs.2016.03.021
19. Touzé E., Randoux B., Méary E. et al. Aneurysmal forms of cervical artery dissection: associated factors and outcome. Stroke 2001;32(2):418–23. DOI: 10.1161/01.str.32.2.418
20. Djouhri H., Guillon B., Brunereau L. et al. MR angiography for the long-term follow-up of dissecting aneurysms of the extracranial internal carotid artery. AJR Am J Roentgenol 2000;174(4):1137–40. DOI: 10.2214/ajr.174.4.1741137
21. Danilova M.S. Catamnesis of patients with dissection of internal carotid and vertebral arteries. Abstract of dis. … cand. med. sci. Moscow, 2022. (In Russ.).
22. Guillon B., Brunereau L., Biousse V. et al. Long-term follow-up of aneurysms developed during extracranial internal carotid artery dissection. Neurology 1999;53(1):117–22. DOI: 10.1212/wnl.53.1.117
23. Simionato F., Righi C., Scotti G. Post-traumatic dissecting aneurysm of extracranial internal carotid artery: endovascular treatment with stenting. Neuroradiology 1999;41(7):543–7. DOI: 10.1007/s002340050801
24. Van Veenendaal P., Maingard J., Kok H.K. et al. Endovascular flow-diversion of visceral and renal artery aneurysms using dual-layer braided nitinol carotid stents. CVIR Endovasc 2020;3(1):33. DOI: 10.1186/s42155-020-00125-2
25. Osuki T., Ikeda H., Uezato M. et al. Aneurysm perforation due to advancement of the coil delivery wire during stent-assisted embolization. Cureus 2022;14(8):e28063. DOI: 10.7759/cureus.28063
26. Maras D., Lioupis C., Magoufis G. et al. Covered stent-graft treatment of traumatic internal carotid artery pseudoaneurysms: a review. Cardiovasc Intervent Radiol 2006;29(6):958–68. DOI: 10.1007/s00270-005-0367-7
Review
For citations:
Belopasova A.V., Sinitsyn I.A., Makarova A.G., Zasypkina E.S., Dreval M.V., Chechetkin A.O., Shchipakin V.L., Dobrynina L.A. Endovascular treatment of giant posttraumatic dissecting aneurysm of internal carotid artery (clinical case and literature review). Russian journal of neurosurgery. 2025;27(1):84-90. (In Russ.) https://doi.org/10.24412/1683-3295-2025-27-1-84-90
Views:
139
Email this article 