Related Experiment Videos
Hemostatic closure device after carotid puncture for stent and coil placement in an intracranial aneurysm: technical
Raphaël Blanc1, Charbel Mounayer, Michel Piotin
1Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France.
Insights
This study details a successful stent and coil placement for a wide-necked carotid cavernous aneurysm in a patient on anticoagulative therapy. An Angio-Seal device facilitated safe closure, avoiding prolonged compression.
Area of Science:
- Interventional neuroradiology
- Vascular surgery
Background:
- Carotid cavernous aneurysms present complex endovascular treatment challenges.
- Patient management requires careful consideration of anticoagulative status and arterial access.
- Minimizing procedural complications is crucial for patient outcomes.
Observation:
- A 71-year-old female with a wide-necked carotid cavernous aneurysm underwent stent and coil embolization.
- Direct common carotid artery puncture was necessary due to arterial tortuosity.
- The procedure was performed during dual antiplatelet and anticoagulative therapy.
Findings:
- Closure of the common carotid artery access site was achieved using an Angio-Seal device.
- This approach avoided prolonged manual or mechanical compression.
- The postoperative period was clinically uneventful, with no immediate complications noted.
Implications:
- Endovascular closure devices can be safely employed in complex carotid artery interventions.
- This technique offers an alternative to prolonged compression, especially in anticoagulated patients.
- Successful treatment of carotid cavernous aneurysms can be achieved with careful procedural planning and execution.
Abstract:
A 71-year-old female patient presented with a wide-necked carotid cavernous aneurysm for which stent and coil placement was planned. Arterial tortuosity required direct puncture of the common carotid artery for access. The procedure was performed while the patient was receiving antiplatelet and anticoagulative therapy. To avoid potentially hazardous and prolonged carotid compression, a closure device (Angio-Seal) was used at the end of the procedure. The postoperative period was clinically uneventful. Sonographic and angiographic follow-up of the carotid artery were performed.