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Traumatic cervical internal carotid artery pseudoaneurysm in a child refractory to initial endovascular treatment: case report and technical considerations

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Abstract

Purpose

Optimal management of extracranial carotid artery dissections (eCAD) in pediatric patients is not well documented, and endovascular interventions are rarely reported.

Methods

A 10-year-old girl sustained multiple systemic injuries in a motor vehicle accident, including an eCAD with pseudoaneurysm. She initially failed both aspirin and endovascular stenting with progressive enlargement of a traumatic cervical carotid pseudoaneurysm and stenosis.

Results

Second-stage endovascular stent placement with coiling resulted in successful occlusion of the pseudoaneurysm. At 30-month imaging follow-up, the parent vessel remained patent with no evidence of the pseudoaneurysm.

Conclusion

In the setting of poly-trauma, management of eCAD can be complex especially in the pediatric population. There is little data on the endovascular treatment of eCAD in children. Failed endovascular therapies are extremely rare. Our report supports surveillance imaging as repeat endovascular treatment may be necessary.

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Authors and Affiliations

  1. Division of Cerebrovascular and Endovascular Neurosurgery, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA

    Arthur Wang, Justin G. Santarelli & Michael F. Stiefel

  2. Westchester Neurovascular Institute, Valhalla, NY, USA

    Justin G. Santarelli & Michael F. Stiefel

Authors
  1. Arthur Wang
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  2. Justin G. Santarelli
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  3. Michael F. Stiefel
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Corresponding author

Correspondence to Arthur Wang.

Ethics declarations

Stents used for conventional intracranial aneurysm treatment such as the Enterprise (Codman, Raynham, Massachusetts) and Neuroform (Stryker NeuroVascular, Fremont, California) are used with Institutional Review Board (IRB) approval and are Human Exemption Device (HDE) status.

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Wang, A., Santarelli, J.G. & Stiefel, M.F. Traumatic cervical internal carotid artery pseudoaneurysm in a child refractory to initial endovascular treatment: case report and technical considerations. Childs Nerv Syst 32, 2459–2464 (2016). https://doi.org/10.1007/s00381-016-3171-6

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  • DOI: https://doi.org/10.1007/s00381-016-3171-6

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