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Overlapped Double-Layer Micromesh Stents for Giant Extracranial Internal Carotid Artery Aneurysm
Tomoaki Murakami1, Shingo Toyota1, Motohide Takahara1
1Department of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.
Objective:
Extracranial internal carotid artery aneurysms (ECAAs) are rare. We herein describe a case of overlapped stenting with two double-layer micromesh stents for a giant ECAA.
Case Presentation:
A 73-year-old man presented to our hospital with an enlarged right posterior cervical mass. A right internal carotid artery (ICA) angiogram revealed a giant aneurysm of 50 × 60 mm. We chose a carotid double-layer micromesh stent for stenting. With the patient under general anesthesia, the first double-layer micromesh stent (CASPER Rx, 10 × 30 mm; Terumo, Tokyo, Japan) was deployed between the ICA distal to the aneurysm and the common carotid artery (CCA). The second stent was also deployed from a site more proximal than the first one. Ten coils were then placed from a microcatheter that had been placed in the aneurysm. A right CCA angiogram after the procedure revealed a flow-diversion effect for the aneurysm. The patient was discharged with no complications. At the 6-month follow-up angiogram, blood flow into the aneurysm had completely disappeared.
Conclusion:
A flow-diversion effect using overlapped double-layer micromesh stents can result in thrombosis and healing of giant ECAAs.
