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Matricidal cavernous aneurysms: a multicenter case series.

Mallory R Dacus1,2, Chris Nickele1,2, Babu G Welch3

  • 1University of Tennessee Health Science Center Department of Neurosurgery, Memphis, Tennessee, USA.

Journal of Neurointerventional Surgery
|March 1, 2019
PubMed
Summary
This summary is machine-generated.

Matricidal aneurysms, a type of cavernous carotid artery aneurysm, can cause parent artery stenosis. Management is complex, with a 28% treatment failure rate in a recent case series, highlighting the need for careful planning.

Keywords:
aneurysmcoilflow diverter

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Area of Science:

  • Neurosurgery
  • Vascular Neurology
  • Interventional Radiology

Background:

  • Cavernous carotid artery aneurysms (CCAs) are unique intracranial aneurysms.
  • Enlarging CCAs can compress the parent internal carotid artery (ICA), causing stenosis.
  • We propose defining these as 'matricidal aneurysms'.

Observation:

  • Forty patients with matricidal aneurysms were analyzed in a multicenter retrospective case series.
  • Patients presented with asymptomatic and symptomatic stenosis.
  • Treatment options included conservative management, coiling, flow diversion, and parent artery sacrifice.

Findings:

  • A 28% treatment failure rate was observed when planned endovascular interventions were attempted.
  • Direct elastic compression by aneurysms does not respond to angioplasty/stenting like atherosclerotic stenosis.
  • Parent vessel sacrifice may be a necessary consideration.

Implications:

  • Matricidal aneurysms require meticulous planning due to challenging cavernous sinus anatomy.
  • Endovascular interventions in this region have a notable failure rate.
  • Consideration of parent vessel sacrifice is crucial for effective management.