Treatment of cervical internal carotid artery spontaneous dissection with pseudoaneurysm and unilateral lower cranial nerves palsy by two silk flow diverters

Cardiovasc Intervent Radiol. 2013 Aug;36(4):1147-50. doi: 10.1007/s00270-012-0472-3. Epub 2012 Oct 16.

Abstract

Internal carotid artery (ICA) lesions in the parapharyngeal space (a dissection and a pseudoaneurysm) may present as isolated lower cranial nerves (IX, X, XI, and XII) palsy (Collet-Sicard syndrome). Some arteriopathies such as fibromuscular dysplasia and tortuosity make a vessel predisposed to dissection. Extreme vessel tortuosity makes the treatment by a stent graft impossible. Two Silk stents were used in a 46 year-old man with left lower cranial nerves (IX-XII) palsy for the treatment of left ICA spontaneous dissection with pseudoaneurysm. A follow-up angiogram 5 months later confirmed pseudoaneurysm thrombosis and patency of the left ICA. The patient recovered completely from the deficits.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False / complications
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / surgery*
  • Blood Vessel Prosthesis Implantation / methods
  • Carotid Artery, Internal, Dissection / complications
  • Carotid Artery, Internal, Dissection / diagnostic imaging
  • Carotid Artery, Internal, Dissection / surgery*
  • Cerebral Angiography / methods
  • Cranial Nerve Diseases / diagnostic imaging
  • Cranial Nerve Diseases / etiology*
  • Cranial Nerve Diseases / surgery
  • Endovascular Procedures / instrumentation*
  • Endovascular Procedures / methods
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Rare Diseases
  • Risk Assessment
  • Silk
  • Stents*
  • Syndrome
  • Treatment Outcome

Substances

  • Silk