Carotid Micromesh Stent for the Cervical Carotid Artery Dissecting Aneurysm in a Patient with Vascular Eagle Syndrome |
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| Institution: | 1. Department of Rehabilitation Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811, Japan;2. Faculty of Medical Science, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama, Kanagawa 244-0806, Japan;3. Department of Rehabilitation Medicine, Sakuragaoka Central Hospital, 1-7-1 Fukuda, Yamato, Kanagawa 242-0024, Japan;4. Department of Neurosurgery, St. Marianna University School of Medicine Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811, Japan;1. Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan;2. Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan;1. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States;2. Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States;3. Icahn School of Medicine at Mount Sinai, New York, NY, United States;1. Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan;2. Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan;3. Department of Neurology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan;4. Department of Neurology, Chugoku Rosai Hospital, Kure, Japan;5. Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan;1. Stroke Unit. Department of Neurology. Hospital UniversitarI Doctor Josep Trueta de Girona. Girona Biomedical Research Institute (IDIBGI). Girona, Spain;2. Statistical and Methodological Advisory Unit, Girona Biomedical Research Institute (IDIBGI), Girona, Spain;3. Cerebrovascular Pathology Research Group, Department of Neurology, Girona Biomedical Research Institute (IDIBGI), Girona, Spain;1. School of Industrial Technology, Advanced Institute of Industrial Technology, Tokyo Metropolitan Public University Corporation, Tokyo, Japan;2. Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan;4. Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Aichi, Japan;5. Department of Community Mental Health & Low, National Center of Neurology and Psychiatry, Tokyo, Japan;6. Department of Dementia and Neuropsychology, Advanced Institute of Industrial Technology, Tokyo Metropolitan Public University Corporation, Tokyo, Japan;7. Department of Cognition and Behavioral Science, Nagoya University Graduate School of Medicine, Aichi, Japan |
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| Abstract: | ObjectivesAn elongated styloid process may cause vascular Eagle syndrome that includes cervical carotid artery (CCA) dissection with stenosis and aneurysm formation. There are only four reported cases with vascular Eagle syndrome-related CCA dissecting aneurysm treated with carotid artery stenting (CAS). This is the first report of applying a dual-layer nitinol micromesh stent (CASPER) for vascular Eagle syndrome-related CCA dissecting aneurysm.Case presentationA 38-year-old man presented with a sudden onset of aphasia and right hemiplegia. Cerebral angiography demonstrated the left CCA dissecting aneurysm. The superior trunk of the left middle cerebral artery (MCA) was also occluded, and emergent thrombectomy was performed. Computed tomography with angiography (CTA) revealed that a 33 mm-long styloid process compressed the CCA at the aneurysm formation. Three weeks later, a CASPER stent was applied for the CCA aneurysm under the flow reversal system. Immediately after stent placement, blood flow in the aneurysm became stagnant, and postoperative CTA demonstrated regression of the aneurysm. The aneurysm did not recur for 6 months with no styloid process resection.ConclusionsThe dual-layer nitinol micromesh stent (CASPER) was useful to treat vascular Eagle syndrome-related CCA dissecting aneurysm. |
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