A rare complication after an interventional procedure using the common carotid: carotid pseudoaneurysm in an infant (original) (raw)

Endovascular management of postoperative pseudoaneurysms of the external carotid artery

Journal of Clinical Neuroscience, 2012

Hemorrhage secondary to postoperative pseudoaneurysm is a rare event, but may complicate the clinical course of straightforward and common interventions such as sinonasal procedures, tonsillectomy, and maxillofacial and plastic surgeries. We report our experience with the endovascular management of iatrogenic pseudoaneurysm in eight patients who had undergone recent craniomaxillofacial surgery. Computed tomography (CT), including CT-angiography, detected only three of the eight lesions. In all patients, endovascular embolization achieved successful occlusion of the pseudoaneurysm without local or general procedure-related complications. Immediate proximal arterial occlusion with detachable coils was performed in every case, and pseudoaneurysm coiling was performed in three cases presenting with active hemorrhage. Endovascular therapy proved to be safe and effective in the management of postoperative pseudoaneurysms. Surgeons involved in the craniomaxillofacial procedures should be aware of this complication and its management.

Carotid artery approach as an alternative to femoral access for balloon dilation of aortic valve stenosis in neonates and infants

The journal of vascular access

to evaluate the efficacy of a right common carotid artery cutdown as alternative access in neonates and small infants requiring a balloon dilation of aortic valve stenosis. In infants, the femoral approach is limited by difficulties in advancing the catheter across the valve and by the risk of femoral artery injuries. from January 1997 to July 2000, 16 infants at our department underwent balloon dilation through a carotid artery cutdown. Infant weight ranged from 2670 to 6450 g; mean weight 3967 g, and age ranged from 1 to 157 days, mean age 42,8 days. Fifteen of 16 infants had aortic valve stenosis; the remaining infant presented with a aortic coartation relapse. In 15 infants an adequate dilation of the valve was obtained with no complications. In only one infant an arterial intimal disconnection was caused by inadequate choice of surgical instruments. At the end of the procedure, the carotid arteries were reconstructed with interrupted 7-0 prolene stitches. There were no neurolog...

Endovascular management of iatrogenic cervical internal carotid artery pseudoaneurysm in a 9-year-old child: Case report and literature review

International Journal of Pediatric Otorhinolaryngology, 2017

Extracranial internal carotid artery (ICA) pseudoaneurysms are uncommon in the pediatric population and are usually secondary to direct trauma to the vessel. Treatment options include surgery (ligation), anticoagulation therapy and endovascular treatment. Endovascular covered stents have shown good results in adult populations, resulting in occlusion of the aneurysm and preservation of the artery without significant complications. However, there have been only limited reports in the literature reporting endovascular carotid stent placement in the pediatric population. We report a case of a 9-yearold boy patient, who developed a cervical ICA pseudoaneurysm after a parapharyngeal tumor resection. He was successfully treated by primary endovascular covered stent placement. During a follow-up of 6 months the patient has been asymptomatic, without any adverse event. Additionally, a literature review is done.

Transtympanic pseudoaneurysm of the internal carotid artery complicating a myringotomy in a four-year old child: Case report and literature review

American Journal of Otolaryngology, 2017

We report the first case of a transtympanic iatrogenic internal carotid artery (ICA) pseudoaneurysm diagnosed in a 4-year-old child following a myringotomy. An endovascular treatment with a covered-stent was decided; spontaneous thrombosis was found during the therapeutic arteriography, and the procedure was aborted. Otoscopy and computed tomography (CT) scan monitoring showed a prolonged thrombosis and the disappearance of the pseudoaneurysm 18 months after the diagnostic arteriography. Based on literature review, endovascular techniques seem to be preferred to the surgical approach for treatment of intrapetrous ICA pseudoaneurysm, however clinical and CT scan monitoring may also be a valid option.

Short- and midterm results of balloon angioplasty for the treatment of coarctation of the aorta in neonates

Turkish Journal of Thoracic and Cardiovascular Surgery, 2012

Bu çalışmada aort koarktasyonlu yenidoğanlarda balon anjiyoplasti ile ilgili klinik deneyimlerimiz, mevcut verilerimiz ve kısa ve orta dönem sonuçlarımız incelendi. Ça lış ma pla nı: Aralık 2004-Mart 2010 tarihleri arasında aort koarktasyonu nedeniyle balon anjiyoplasti uygulanan 51 yenidoğana (41 erkek, 10 kız; ort. yaş 13±9 gün; dağılım 1-30 gün) ait veriler retrospektif olarak incelendi. Bul gu lar: Olguların 13'ünde (%25) izole koarktasyon, 38'inde (%75) kompleks koarktasyon tespit edildi. On sekiz hastada (%35.3) sol ventrikül disfonksiyonu, 17 hastada (%33.3) isthmus hipoplazisi görüldü. En sık eşlik eden anomali, ventriküler septal defekt (VSD) (%49) idi. Yirmi dokuz hastada (%56.9) pulmoner hipertansiyon vardı. Koarktasyon bölgesinde ortalama sistolik basınç gradiyenti dilatasyon öncesi 36±20 mmHg iken, dilatasyon sonrası 8.6±7.0 mmHg'ye düştü. Bir hastada femoral arter trombozu gelişti. Ortalama izlem süresi 8.7±9.6 ay (dağılım 1-46 ay, ortanca 6 ay) idi. İşlem sonrası ortalama 3.2±3.1 ay sonra 20 hastada (%39.2) rekoarktasyon gelişti. Rekoarktasyon gelişen hastaların dokuzuna (%45) tekrar anjiyoplasti, 11'ine (%55) cerrahi işlem uygulandı. Bir-yedi aylık izlemde yedi hasta (%13.7) kaybedildi. So nuç:Kısa ve orta izlem sonuçlarına göre balon anjiyoplasti, cerrahi işleme göre yüksek rekoarktasyon oranına sahiptir. Bu nedenle balon anjiyoplasti, kompleks kardiyak hastalığı olan ve genel durumu kötü olan hastalarda tam düzeltme ameliyatı yapılana dek sağkalım için uygulanmalıdır. Anah tar söz cük ler: Aort koarktasyonu; balon anjiyoplasti; yenidoğan. Background:In this study, we reviewed our clinical experience along with the existing data and short-and midterm results of balloon angioplasty for coarctation of aorta in neonates. Methods: The data of 51 neonates (41 boys and 10 girls; mean age 13±9 days; range 1 to 30 days) who underwent balloon angioplasty for aortic coarctation between December 2004 and March 2010 were retrospectively analyzed. Results:Isolated coarctation was found in 13 patients (25%) and complex coarctation in 38 (75%). The left ventricular dysfunction was seen in 18 patients (35.3%), while 17 patients (33.3%) had isthmus hypoplasia. The most common concomitant abnormality was ventricular septal defect (VSD) (49%). Twenty-nine patients (56.9%) had pulmonary hypertension. The mean systolic pressure gradient across the coarctation site fell from 36±20 mmHg before dilatation to 8.6±7.0 mmHg following the intervention. One patient developed femoral artery thrombosis. The mean follow-up was 8.7±9.6 months (range 1-46, median 6 months). Recoarctation developed in 20 patients (39.2%) after an average 3.2±3.1 months. Of these, nine (45%) with recoarctation underwent repeated angioplasty and 11 (55%) surgical repair. During follow-up of 1-7 months, seven (13.7%) patients died. Conclusion: Our short-and midterm results suggest that balloon angioplasty has a higher recoarctation rate than surgery. Therefore, balloon angioplasty should be done to ensure survival until full corrective surgery is performed in patients with complex cardiac disease and poor overall condition.