Treatment of Symptomatic Bilateral Cavernous Carotid Aneurysms: Long-term Results of 6 Cases
Background Bilateral cavernous carotid aneurysms (CCAs) are very rare. A treatment strategy for symptomatic bilateral CCAs has not been established because of their complex pathogenesis. Here we report our treatment strategy and long-term results for 6 cases of symptomatic bilateral CCAs. Methods Fr...
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| Veröffentlicht in: | Journal of stroke and cerebrovascular diseases 2015-05, Vol.24 (5), p.1013-1018 |
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| creator | Uozumi, Yoichi, MD, PhD Okamoto, Sho, MD, PhD Araki, Yoshio, MD, PhD Izumi, Takashi, MD, PhD Matsubara, Noriaki, MD, PhD Yokoyama, Kinya, MD Sumitomo, Masaki, MD, PhD Miyachi, Shigeru, MD, PhD Wakabayashi, Toshihiko, MD, PhD |
| description | Background Bilateral cavernous carotid aneurysms (CCAs) are very rare. A treatment strategy for symptomatic bilateral CCAs has not been established because of their complex pathogenesis. Here we report our treatment strategy and long-term results for 6 cases of symptomatic bilateral CCAs. Methods From January 2007 to December 2013, we treated 6 patients (2 men and 4 women; mean age at first treatment, 56.0 years) with symptomatic bilateral CCAs. Results All patients began to experience unilateral symptoms. Five of the 6 underwent high-flow bypass (HFB) with parent artery occlusion (PAO), and 1 received PAO only. Mean follow-up period after the first treatment was 61.3 months. All symptoms improved after the treatment. Five contralateral CCAs became enlarged during the follow-up period. Of these, 4 became symptomatic. One patient received superficial temporal–middle cerebral artery bypass with PAO, 2 received HFB with PAO, and 1 refused treatment. Final modified Rankin Scale scores were 0 in 4 patients, 1 in 1 patient, and 2 in 1 patient. There was no mortality in this series. Conclusions HFB with PAO is feasible as the first treatment for symptomatic bilateral CCAs. This treatment strategy steadies and simplifies future treatment of contralateral CCAs should they become symptomatic. |
| doi_str_mv | 10.1016/j.jstrokecerebrovasdis.2014.12.027 |
| format | Article |
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A treatment strategy for symptomatic bilateral CCAs has not been established because of their complex pathogenesis. Here we report our treatment strategy and long-term results for 6 cases of symptomatic bilateral CCAs. Methods From January 2007 to December 2013, we treated 6 patients (2 men and 4 women; mean age at first treatment, 56.0 years) with symptomatic bilateral CCAs. Results All patients began to experience unilateral symptoms. Five of the 6 underwent high-flow bypass (HFB) with parent artery occlusion (PAO), and 1 received PAO only. Mean follow-up period after the first treatment was 61.3 months. All symptoms improved after the treatment. Five contralateral CCAs became enlarged during the follow-up period. Of these, 4 became symptomatic. One patient received superficial temporal–middle cerebral artery bypass with PAO, 2 received HFB with PAO, and 1 refused treatment. Final modified Rankin Scale scores were 0 in 4 patients, 1 in 1 patient, and 2 in 1 patient. There was no mortality in this series. Conclusions HFB with PAO is feasible as the first treatment for symptomatic bilateral CCAs. This treatment strategy steadies and simplifies future treatment of contralateral CCAs should they become symptomatic.</description><identifier>ISSN: 1052-3057</identifier><identifier>EISSN: 1532-8511</identifier><identifier>DOI: 10.1016/j.jstrokecerebrovasdis.2014.12.027</identifier><identifier>PMID: 25813060</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aneurysm - complications ; Aneurysm - therapy ; Bilateral cavernous carotid aneurysms ; bypass surgery ; Cardiovascular ; Carotid Artery Diseases - complications ; Carotid Artery Diseases - therapy ; Cavernous Sinus - pathology ; Cerebral Revascularization - methods ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Neurology ; parent artery occlusion ; Retrospective Studies ; treatment</subject><ispartof>Journal of stroke and cerebrovascular diseases, 2015-05, Vol.24 (5), p.1013-1018</ispartof><rights>National Stroke Association</rights><rights>2015 National Stroke Association</rights><rights>Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c595t-2b5f790279388900c118f5f5d32ad6368b79b4af8f6ef902c2f55cdb378c9bdc3</citedby><cites>FETCH-LOGICAL-c595t-2b5f790279388900c118f5f5d32ad6368b79b4af8f6ef902c2f55cdb378c9bdc3</cites><orcidid>0000-0002-4997-6042</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1052305714006405$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25813060$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uozumi, Yoichi, MD, PhD</creatorcontrib><creatorcontrib>Okamoto, Sho, MD, PhD</creatorcontrib><creatorcontrib>Araki, Yoshio, MD, PhD</creatorcontrib><creatorcontrib>Izumi, Takashi, MD, PhD</creatorcontrib><creatorcontrib>Matsubara, Noriaki, MD, PhD</creatorcontrib><creatorcontrib>Yokoyama, Kinya, MD</creatorcontrib><creatorcontrib>Sumitomo, Masaki, MD, PhD</creatorcontrib><creatorcontrib>Miyachi, Shigeru, MD, PhD</creatorcontrib><creatorcontrib>Wakabayashi, Toshihiko, MD, PhD</creatorcontrib><title>Treatment of Symptomatic Bilateral Cavernous Carotid Aneurysms: Long-term Results of 6 Cases</title><title>Journal of stroke and cerebrovascular diseases</title><addtitle>J Stroke Cerebrovasc Dis</addtitle><description>Background Bilateral cavernous carotid aneurysms (CCAs) are very rare. A treatment strategy for symptomatic bilateral CCAs has not been established because of their complex pathogenesis. Here we report our treatment strategy and long-term results for 6 cases of symptomatic bilateral CCAs. Methods From January 2007 to December 2013, we treated 6 patients (2 men and 4 women; mean age at first treatment, 56.0 years) with symptomatic bilateral CCAs. Results All patients began to experience unilateral symptoms. Five of the 6 underwent high-flow bypass (HFB) with parent artery occlusion (PAO), and 1 received PAO only. Mean follow-up period after the first treatment was 61.3 months. All symptoms improved after the treatment. Five contralateral CCAs became enlarged during the follow-up period. Of these, 4 became symptomatic. One patient received superficial temporal–middle cerebral artery bypass with PAO, 2 received HFB with PAO, and 1 refused treatment. Final modified Rankin Scale scores were 0 in 4 patients, 1 in 1 patient, and 2 in 1 patient. There was no mortality in this series. Conclusions HFB with PAO is feasible as the first treatment for symptomatic bilateral CCAs. This treatment strategy steadies and simplifies future treatment of contralateral CCAs should they become symptomatic.</description><subject>Adult</subject><subject>Aged</subject><subject>Aneurysm - complications</subject><subject>Aneurysm - therapy</subject><subject>Bilateral cavernous carotid aneurysms</subject><subject>bypass surgery</subject><subject>Cardiovascular</subject><subject>Carotid Artery Diseases - complications</subject><subject>Carotid Artery Diseases - therapy</subject><subject>Cavernous Sinus - pathology</subject><subject>Cerebral Revascularization - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>parent artery occlusion</subject><subject>Retrospective Studies</subject><subject>treatment</subject><issn>1052-3057</issn><issn>1532-8511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkU9r3DAQxU1padK0X6H4WAp2NfLKlnsoJEv_BBYCTXorCFkeFTm2tdXIC_vtI7NpDyWXnmYOv3nz5k2WvQdWAoP6w1AOFIO_R4MBu-APmnpHJWewKYGXjDfPsnMQFS-kAHieeiZ4UTHRnGWviAbGAIQUL7MzLiRUrGbn2c-7gDpOOMfc2_z2OO2jn3R0Jr9yo44Y9Jhv9QHD7BdKXfDR9fnljEs40kQf852ffxWJm_LvSMsYadWpE0lIr7MXVo-Ebx7rRfbjy-e77bdid_P1enu5K4xoRSx4J2zTJvttJWXLmAGQVljRV1z3dVXLrmm7jbbS1mgTZ7gVwvRd1UjTdr2pLrJ3J9198L8XpKgmRwbHUc-YbCuoGyGbtmGQ0KsTaoInCmjVPrhJh6MCptaU1aCeSlmtKSvgKtlMIm8f9y3dhP1fiT-xJmB3AjBdfXAYFBmHs8HeBTRR9d79375P_8iZ0c3O6PEej0iDX8Kc8lWgKA2o2_Xv69thw1i9YaJ6AGxfsdk</recordid><startdate>20150501</startdate><enddate>20150501</enddate><creator>Uozumi, Yoichi, MD, PhD</creator><creator>Okamoto, Sho, MD, PhD</creator><creator>Araki, Yoshio, MD, PhD</creator><creator>Izumi, Takashi, MD, PhD</creator><creator>Matsubara, Noriaki, MD, PhD</creator><creator>Yokoyama, Kinya, MD</creator><creator>Sumitomo, Masaki, MD, PhD</creator><creator>Miyachi, Shigeru, MD, PhD</creator><creator>Wakabayashi, Toshihiko, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4997-6042</orcidid></search><sort><creationdate>20150501</creationdate><title>Treatment of Symptomatic Bilateral Cavernous Carotid Aneurysms: Long-term Results of 6 Cases</title><author>Uozumi, Yoichi, MD, PhD ; Okamoto, Sho, MD, PhD ; Araki, Yoshio, MD, PhD ; Izumi, Takashi, MD, PhD ; Matsubara, Noriaki, MD, PhD ; Yokoyama, Kinya, MD ; Sumitomo, Masaki, MD, PhD ; Miyachi, Shigeru, MD, PhD ; Wakabayashi, Toshihiko, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c595t-2b5f790279388900c118f5f5d32ad6368b79b4af8f6ef902c2f55cdb378c9bdc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aneurysm - complications</topic><topic>Aneurysm - therapy</topic><topic>Bilateral cavernous carotid aneurysms</topic><topic>bypass surgery</topic><topic>Cardiovascular</topic><topic>Carotid Artery Diseases - complications</topic><topic>Carotid Artery Diseases - therapy</topic><topic>Cavernous Sinus - pathology</topic><topic>Cerebral Revascularization - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>parent artery occlusion</topic><topic>Retrospective Studies</topic><topic>treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uozumi, Yoichi, MD, PhD</creatorcontrib><creatorcontrib>Okamoto, Sho, MD, PhD</creatorcontrib><creatorcontrib>Araki, Yoshio, MD, PhD</creatorcontrib><creatorcontrib>Izumi, Takashi, MD, PhD</creatorcontrib><creatorcontrib>Matsubara, Noriaki, MD, PhD</creatorcontrib><creatorcontrib>Yokoyama, Kinya, MD</creatorcontrib><creatorcontrib>Sumitomo, Masaki, MD, PhD</creatorcontrib><creatorcontrib>Miyachi, Shigeru, MD, PhD</creatorcontrib><creatorcontrib>Wakabayashi, Toshihiko, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of stroke and cerebrovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uozumi, Yoichi, MD, PhD</au><au>Okamoto, Sho, MD, PhD</au><au>Araki, Yoshio, MD, PhD</au><au>Izumi, Takashi, MD, PhD</au><au>Matsubara, Noriaki, MD, PhD</au><au>Yokoyama, Kinya, MD</au><au>Sumitomo, Masaki, MD, PhD</au><au>Miyachi, Shigeru, MD, PhD</au><au>Wakabayashi, Toshihiko, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of Symptomatic Bilateral Cavernous Carotid Aneurysms: Long-term Results of 6 Cases</atitle><jtitle>Journal of stroke and cerebrovascular diseases</jtitle><addtitle>J Stroke Cerebrovasc Dis</addtitle><date>2015-05-01</date><risdate>2015</risdate><volume>24</volume><issue>5</issue><spage>1013</spage><epage>1018</epage><pages>1013-1018</pages><issn>1052-3057</issn><eissn>1532-8511</eissn><abstract>Background Bilateral cavernous carotid aneurysms (CCAs) are very rare. A treatment strategy for symptomatic bilateral CCAs has not been established because of their complex pathogenesis. Here we report our treatment strategy and long-term results for 6 cases of symptomatic bilateral CCAs. Methods From January 2007 to December 2013, we treated 6 patients (2 men and 4 women; mean age at first treatment, 56.0 years) with symptomatic bilateral CCAs. Results All patients began to experience unilateral symptoms. Five of the 6 underwent high-flow bypass (HFB) with parent artery occlusion (PAO), and 1 received PAO only. Mean follow-up period after the first treatment was 61.3 months. All symptoms improved after the treatment. Five contralateral CCAs became enlarged during the follow-up period. Of these, 4 became symptomatic. One patient received superficial temporal–middle cerebral artery bypass with PAO, 2 received HFB with PAO, and 1 refused treatment. Final modified Rankin Scale scores were 0 in 4 patients, 1 in 1 patient, and 2 in 1 patient. There was no mortality in this series. Conclusions HFB with PAO is feasible as the first treatment for symptomatic bilateral CCAs. This treatment strategy steadies and simplifies future treatment of contralateral CCAs should they become symptomatic.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25813060</pmid><doi>10.1016/j.jstrokecerebrovasdis.2014.12.027</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-4997-6042</orcidid></addata></record> |
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| subjects | Adult Aged Aneurysm - complications Aneurysm - therapy Bilateral cavernous carotid aneurysms bypass surgery Cardiovascular Carotid Artery Diseases - complications Carotid Artery Diseases - therapy Cavernous Sinus - pathology Cerebral Revascularization - methods Female Humans Longitudinal Studies Male Middle Aged Neurology parent artery occlusion Retrospective Studies treatment |
| title | Treatment of Symptomatic Bilateral Cavernous Carotid Aneurysms: Long-term Results of 6 Cases |
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