Tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms

Jessica K. Campos, Li Mei Lin, Narlin B. Beaty, Matthew T. Bender, Bowen Jiang, David A. Zarrin, Alexander Coon

Research output: Contribution to journalArticle

Abstract

Background: An estimated 2%-3% of the population harbour an intracranial aneurysm. Concomitant atherosclerotic cervical carotid disease is not uncommon. The management of these two entities remains a challenge within the field. Case presentation: We report a single case of concomitant carotid stenosis and two ipsilateral unruptured intracranial aneurysms treated with a single-staged cervical carotid stenting and cerebral aneurysm embolisation with the Pipeline embolisation device. Discussion: No consensus currently exists to guide endovascular treatment of intracranial aneurysms associated with asymptomatic ipsilateral stenosis. Here, we present a case of asymptomatic moderate carotid stenosis with two ipsilateral intracranial aneurysms and suggest carotid artery stenting takes procedural priority over aneurysm embolisation in single-stage treatment. The rationale for the sequence of neurointerventions is based on the tracking a robust distal access system beyond a stenotic proximal carotid lesion and stabilisation of the ulcerated plaque to avoid thromboembolic complications associated with plaque irritation during aneurysm embolisation. Additional cases and longer follow-up will be needed to further assess the efficacy of this technique.

Original languageEnglish (US)
JournalStroke and Vascular Neurology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Carotid Stenosis
Intracranial Aneurysm
Aneurysm
Carotid Artery Diseases
Carotid Arteries
Pathologic Constriction
Equipment and Supplies
Population

Keywords

  • aneurysm
  • flow diverter
  • stenosis
  • stent

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms. / Campos, Jessica K.; Lin, Li Mei; Beaty, Narlin B.; Bender, Matthew T.; Jiang, Bowen; Zarrin, David A.; Coon, Alexander.

In: Stroke and Vascular Neurology, 01.01.2018.

Research output: Contribution to journalArticle

Campos, Jessica K. ; Lin, Li Mei ; Beaty, Narlin B. ; Bender, Matthew T. ; Jiang, Bowen ; Zarrin, David A. ; Coon, Alexander. / Tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms. In: Stroke and Vascular Neurology. 2018.
@article{0d9b0f81a44a4c33b09c2aaf1182a8f0,
title = "Tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms",
abstract = "Background: An estimated 2{\%}-3{\%} of the population harbour an intracranial aneurysm. Concomitant atherosclerotic cervical carotid disease is not uncommon. The management of these two entities remains a challenge within the field. Case presentation: We report a single case of concomitant carotid stenosis and two ipsilateral unruptured intracranial aneurysms treated with a single-staged cervical carotid stenting and cerebral aneurysm embolisation with the Pipeline embolisation device. Discussion: No consensus currently exists to guide endovascular treatment of intracranial aneurysms associated with asymptomatic ipsilateral stenosis. Here, we present a case of asymptomatic moderate carotid stenosis with two ipsilateral intracranial aneurysms and suggest carotid artery stenting takes procedural priority over aneurysm embolisation in single-stage treatment. The rationale for the sequence of neurointerventions is based on the tracking a robust distal access system beyond a stenotic proximal carotid lesion and stabilisation of the ulcerated plaque to avoid thromboembolic complications associated with plaque irritation during aneurysm embolisation. Additional cases and longer follow-up will be needed to further assess the efficacy of this technique.",
keywords = "aneurysm, flow diverter, stenosis, stent",
author = "Campos, {Jessica K.} and Lin, {Li Mei} and Beaty, {Narlin B.} and Bender, {Matthew T.} and Bowen Jiang and Zarrin, {David A.} and Alexander Coon",
year = "2018",
month = "1",
day = "1",
doi = "10.1136/svn-2018-000187",
language = "English (US)",
journal = "Stroke and Vascular Neurology",
issn = "2059-8688",
publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - Tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms

AU - Campos, Jessica K.

AU - Lin, Li Mei

AU - Beaty, Narlin B.

AU - Bender, Matthew T.

AU - Jiang, Bowen

AU - Zarrin, David A.

AU - Coon, Alexander

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: An estimated 2%-3% of the population harbour an intracranial aneurysm. Concomitant atherosclerotic cervical carotid disease is not uncommon. The management of these two entities remains a challenge within the field. Case presentation: We report a single case of concomitant carotid stenosis and two ipsilateral unruptured intracranial aneurysms treated with a single-staged cervical carotid stenting and cerebral aneurysm embolisation with the Pipeline embolisation device. Discussion: No consensus currently exists to guide endovascular treatment of intracranial aneurysms associated with asymptomatic ipsilateral stenosis. Here, we present a case of asymptomatic moderate carotid stenosis with two ipsilateral intracranial aneurysms and suggest carotid artery stenting takes procedural priority over aneurysm embolisation in single-stage treatment. The rationale for the sequence of neurointerventions is based on the tracking a robust distal access system beyond a stenotic proximal carotid lesion and stabilisation of the ulcerated plaque to avoid thromboembolic complications associated with plaque irritation during aneurysm embolisation. Additional cases and longer follow-up will be needed to further assess the efficacy of this technique.

AB - Background: An estimated 2%-3% of the population harbour an intracranial aneurysm. Concomitant atherosclerotic cervical carotid disease is not uncommon. The management of these two entities remains a challenge within the field. Case presentation: We report a single case of concomitant carotid stenosis and two ipsilateral unruptured intracranial aneurysms treated with a single-staged cervical carotid stenting and cerebral aneurysm embolisation with the Pipeline embolisation device. Discussion: No consensus currently exists to guide endovascular treatment of intracranial aneurysms associated with asymptomatic ipsilateral stenosis. Here, we present a case of asymptomatic moderate carotid stenosis with two ipsilateral intracranial aneurysms and suggest carotid artery stenting takes procedural priority over aneurysm embolisation in single-stage treatment. The rationale for the sequence of neurointerventions is based on the tracking a robust distal access system beyond a stenotic proximal carotid lesion and stabilisation of the ulcerated plaque to avoid thromboembolic complications associated with plaque irritation during aneurysm embolisation. Additional cases and longer follow-up will be needed to further assess the efficacy of this technique.

KW - aneurysm

KW - flow diverter

KW - stenosis

KW - stent

UR - http://www.scopus.com/inward/record.url?scp=85058807486&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058807486&partnerID=8YFLogxK

U2 - 10.1136/svn-2018-000187

DO - 10.1136/svn-2018-000187

M3 - Article

JO - Stroke and Vascular Neurology

JF - Stroke and Vascular Neurology

SN - 2059-8688

ER -