Life Threatening Transmural Arteritis of the Internal Carotid Artery: Reconstructive Treatment with Flow Diverting Stents

Excerpt

Inflammation of the paranasal sinuses is a common and usually benign disease. However, transmural involvement of the internal carotid artery with subsequent aneurysm formation and/or embolic stroke has been described as rare but severe complication [1‐7]. Endovascular treatment by means of coil occlusion of the aneurysm sac may avoid aneurysm rupture, but does not address the inflammatory changes of the vessel wall; implantation of conventional stents is usually not sufficient to reconstruct the affected vessel segment. Definite occlusion of the affected vessel remains the last treatment option in severe cases when collateral supply is sufficient. We present two cases of sinusitis with transmural involvement of the internal carotid artery (ICA) and aneurysm formation causing life threatening epistaxis in which a complete vessel reconstruction was achieved by means of overlapping flow diverting stents. …