Article (Scientific journals)
Sequential successful surgical management of extracranial internal carotid stenosis and ipsilateral intracranial aneurysm. Case reports.
Detry, Olivier; Defraigne, Jean-Olivier; Desiron, Quentin et al.
1997In Vascular Surgery, 31, p. 179-185
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Abstract :
[en] The coexistence of extracranial internal carotid stenosis and ipsilateral intracranial aneurysm is a rare event whose management is controversial. Theoretically, the correction of a significant stenosis of the extracranial internal carotid may lead to an increase in the downstream pressure in the intracranial carotid, and may consequently increase the risk of rupture of the ipsilateral aneurysm. Moreover, dramatic increase of blood pressure is not uncommon after carotid endarterectomy, and may promote aneurysmal rupture. Intracranial surgical correction of a hypoperfused aneurysm down to extracranial carotid stenosis should carry an increased risk of inadequate cerebral flow during procedure, and unspecific postoperative stimulation of platelets aggregation and coagulation may complete obstruction of a subtotal carotid stenosis. We report the cases of two patients successfully treated by a two-stage surgical procedure. In a first step, the intracerebral aneurysms were controlled and electively excluded by clipping. In a second step, carotid endarteriectomies were performed some days later without any neurological complications. Postoperative recoveries were uneventful and six months after these surgical procedures, clinical examination of both patients did not reveal any worsening of the preoperative neurological status.
Disciplines :
Neurology
Surgery
Cardiovascular & respiratory systems
Author, co-author :
Detry, Olivier  ;  Université de Liège - ULiège > Chirurgie abdominale- endocrinienne et de transplantation
Defraigne, Jean-Olivier ;  Université de Liège - ULiège > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique
Desiron, Quentin ;  Université de Liège - ULiège > Chirurgie cardio-vasculaire
Martin, Didier  ;  Université de Liège - ULiège > Neurochirurgie
Born, Jacques
Hans, Pol ;  Université de Liège - ULiège > Anesthésie et réanimation
Limet, Raymond ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Language :
English
Title :
Sequential successful surgical management of extracranial internal carotid stenosis and ipsilateral intracranial aneurysm. Case reports.
Publication date :
March 1997
Journal title :
Vascular Surgery
ISSN :
0042-2835
Publisher :
Westminster Publications, Glen Head, United States - New York
Volume :
31
Pages :
179-185
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 21 September 2009

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