Successful kissing balloon expandable stent graft treatment for a right common carotid pseudoaneurysm caused by tracheotomy.

Successful kissing balloon expandable stent graft treatment for a right common carotid pseudoaneurysm caused by tracheotomy.

World Neurosurg. 2018 Mar 27;:

Authors: Agyei JO, Alvarez C, Iqbal A, Fanous AA, Siddiqui AH

Abstract
BACKGROUND: A rare complication following a tracheotomy is common carotid artery (CCA) pseudoaneurysm. There are many treatment modalities for CCA pseudoaneurysm including surgical repair and single-artery balloon-covered stent-graft technique. We present successful treatment of a tracheotomy-related CCA pseudoaneurysm with the "kissing balloon" expandable stent-graft technique.
CASE DESCRIPTION: We successfully implemented the "kissing balloon" expandable stent-graft technique for the treatment of a large, narrow-necked, bilobed CCA pseudoaneurysm that arose due to a tracheotomy complication. The pseudoaneurysm was detected while performing a diagnostic angiogram of the aortic arch and surrounding vessels. The stent was deployed while the 2 balloons were introduced in a kissing manner such that they faced one another to avoid occlusion of one or the other branch of the innominate artery coming into contact; one balloon was inflated at the origin of the right subclavian artery, and the other was inflated at the right innominate artery simultaneously.. The pseudoaneurysm was successfully contained; and normal blood flow was restored in the CCA. The balloons were deflated and withdrawn. The patient remained neurologically intact after the procedure.
RESULTS: This case report demonstrates the treatment of a CCA pseudoaneurysm by use of the kissing balloon expandable stent-graft technique. Kissing balloon technique is a safe and effective alternative to surgical repair because it prevents the various morbidities associated with the surgical procedure. In addition, this technique decreases the risk of major side-branch occlusion associated with the single-artery balloon-covered stent-graft technique.

PMID: 29602007 [PubMed - as supplied by publisher]

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