Endovascular Coil Embolization for Intracranial Aneurysm Accessing by Common Carotid Artery

, Hong Suk Ahn1; , Hong Jun Jeon1,2; , Jong Young Lee1; , Jong Hwa Park1,2; , Seoung Woo Park2; , Byung Moon Cho1

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2018;14(2):66-71.
Published online September 1, 2018.

Endovascular Coil Embolization for Intracranial Aneurysm Accessing by Common Carotid Artery

Hong Suk Ahn1 , Hong Jun Jeon1,2 , Jong Young Lee1 , Jong Hwa Park1,2 , Seoung Woo Park2 , Byung Moon Cho1

¹Department of Neurosurgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul; ²Department of Neurosurgery, Gangwon National University College of Medicine, Chuncheon, Korea

총경동맥을 통한 뇌동맥류 환자의 혈관내 코일 색전술

안홍석¹·전홍준^1,2·이종영¹·박종화^1,2·박승우²·조병문¹

한림대학교 의과대학 강동성심병원 신경외과학교실, 강원대학교 의과대학 신경외과학교실

Abstract

Objective
Common femoral artery is common route for neurointerventional procedure. Sometimes, complicated accessing route of geriatric patients disturbs the conventional route. Therefore, we introduce transcervical access via direct exposure of common carotid artery(CCA) at the hybrid operating room.
Methods
From September 2014 to December 2017, we performed 10 cases of coil embolization through transcervical route though the CCA at the hybrid operating room(transcervical group). We compared them with conventional coil embolization cases in old aged patients(conventional group). After exposure of CCA, 6~8Fr guiding catheter was placed with subcutaneous tunneling. Then coil embolization was successfully done through guiding catheter. All puncture site was closed with direct suture.
Results
Mean age of transcervical group was 78.4(72-84), and conventional group was 77.5(70-83). All aneurysms were located on anterior circulation. Both groups consist 5 ruptured aneurysms and 5 unruptured aneurysms. None of the patients with unruptured aneurysm had newly developed symptoms. In transcervical group, of the five patients with ruptured aneurysms, two patients exhibited good outcomes(Glasgow Outcome Scale 4 or 5) but two patients expired(Glasgow Outcome Scale 1) due to initial insult. This result was similar in conventional group.
Conclusion
When the femoral route is unfavorable due to anatomical problems, transcervical access through direct exposure of the CCA can be an alternative option.

Key Words: Carotid artery, Common, Intracranial aneurysm, Operating rooms