Ruptured Aneurysm of an Aberrant Internal Carotid Artery Successfully Treated with Simultaneous Intervention and Surgery in a Hybrid Operating Room.

Related Articles

Ruptured Aneurysm of an Aberrant Internal Carotid Artery Successfully Treated with Simultaneous Intervention and Surgery in a Hybrid Operating Room.

World Neurosurg. 2017 Apr 05;:

Authors: Kawamura Y, Sayama T, Maehara N, Nishimura A, Iihara K

Abstract
BACKGROUND: Aberrant internal carotid artery (aICA) is an anatomical anomaly whereby the internal carotid artery (ICA) courses through the tympanic cavity without separation by bone. Since aICA is rare, there are no definite treatment strategies for aICA and its complications.
CASE DESCRIPTION: We report a case of aICA accompanied by pseudoaneurysm formation and massive bleeding. Our case was a 31-year-old woman with a 2-year history of hearing loss, ear fullness, and pulsatile tinnitus in her left ear. Following a diagnosis of otitis media with effusion, she underwent a myringotomy and massive arterial bleeding occurred. After the bleeding was temporarily stopped, aICA and pseudoaneurysm formation on the aICA was revealed. To prevent rebleeding, we performed endovascular internal trapping around the pseudoaneurysm after performing common carotid artery to radial artery to middle cerebral artery bypass grafting. After surgery, the aneurysm disappeared. In addition, no new neurological complications were observed, and her hearing improved and the tinnitus diminished.
CONCLUSIONS: This is the first case report of an aICA complicated by pseudoaneurysm formation successfully treated with simultaneous endovascular trapping and high flow bypass in a hybrid operating room.

PMID: 28391020 [PubMed - as supplied by publisher]

http://ift.tt/2oWREO8