Endovascular Treatment of 147 Cases of Cavernous Carotid Aneurysms: A Single-Center Experience

Ning Guan; Shiqing Mu; Linyuan Wang; Xiaochuan Huo; Yuhua Jiang; Xianli Lv; Youxiang Li

doi:10.1016/j.jstrokecerebrovasdis.2016.04.012

Endovascular Treatment of 147 Cases of Cavernous Carotid Aneurysms: A Single-Center Experience

J Stroke Cerebrovasc Dis. 2016 Aug;25(8):1929-35. doi: 10.1016/j.jstrokecerebrovasdis.2016.04.012. Epub 2016 May 13.

Authors

Ning Guan¹, Shiqing Mu¹, Linyuan Wang², Xiaochuan Huo¹, Yuhua Jiang¹, Xianli Lv¹, Youxiang Li³

Affiliations

¹ Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² Department of Periodontics, The Second Affiliated Hospital of Liaoning Medical College, Jinzhou, Liaoning, China.
³ Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: liyouxianglyx@126.com.

PMID: 27185537
DOI: 10.1016/j.jstrokecerebrovasdis.2016.04.012

Abstract

Background: Cavernous carotid aneurysms (CCAs) are characterized by pain and neuro-ophthalmologic deficits. The optimal treatment remains unclear, especially for asymptomatic CCAs. This study investigated the efficacy of endovascular treatment for CCAs in our center.

Methods: Data obtained from patients who underwent endovascular treatment for CCAs from July 2011 to July 2014 were reviewed. A retrospective analysis was conducted regarding the general condition, clinical presentation, aneurysm characteristics, therapeutic strategy, and prognosis of CCA patients.

Results: One hundred forty-seven patients who exhibited 155 CCAs were included, which comprised 46 asymptomatic and 101 symptomatic CCA cases. Forty-eight cases presented with headache, 5 cases presented with subarachnoid hemorrhage, 20 cases presented with diplopia, 38 cases presented with cranial nerve palsy, and 27 cases presented with ischemic stroke. The mean aneurysm sizes were 15.3 ± 12.2 and 8.1 ± 7.1 mm in the symptomatic and asymptomatic groups, respectively. Different treatments were administered: coil occlusion (n = 15), stent/balloon-assisted coil occlusion (n = 123), and parent artery occlusion (PAO) (n = 17). The PAO-treated group exhibited the highest aneurysm occlusion rate. Follow-up data were available for 131 cases, which included 86 symptomatic and 45 asymptomatic cases. There were no deaths. Among the symptomatic patients, 40.7% improved, 58.1% remained stable, and 1.2% worsened; 12 patients exhibited regrowth and 6 patients had repeated endovascular treatment. The asymptomatic patients remained stable, including 5 patients who exhibited regrowth and 2 patients who had repeated endovascular treatment.

Conclusion: Endovascular treatment is safe and effective for CCAs and should be considered in patients with minimal complications, as well as in asymptomatic patients with stable symptoms.

Keywords: Cavernous carotid aneurysm; balloon; coil occlusion; endovascular treatment; parent artery occlusion; stent.

MeSH terms

Adult
Aspirin / therapeutic use
Cerebral Angiography
Clopidogrel
Embolization, Therapeutic / methods*
Female
Follow-Up Studies
Heart Aneurysm / complications*
Heart Aneurysm / drug therapy
Heart Aneurysm / surgery*
Humans
Intracranial Aneurysm / complications*
Intracranial Aneurysm / drug therapy
Intracranial Aneurysm / surgery*
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Retrospective Studies
Ticlopidine / analogs & derivatives
Ticlopidine / therapeutic use
Treatment Outcome

Substances

Platelet Aggregation Inhibitors
Clopidogrel
Ticlopidine
Aspirin