• M J Perez-Cruet, R V Patwardhan, M E Mawad, and J E Rose.
• Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
• Neurosurgery. 1997 Mar 1; 40 (3): 622-5; discussion 625-6.

Objective And ImportanceThis case illustrates the use of an endovascular stent and coiling combination to treat a giant wide-necked pseudoaneurysm of the cervical internal carotid artery.Clinical PresentationA 20-year-old male patient presented with a bilateral dissection of the cervical internal carotid artery and a right giant wide-necked pseudoaneurysm of the cervical segment of the internal carotid artery after a high-speed motor vehicle collision.InterventionAfter failing conservative therapy, the patient was treated by endovascular placement of a Palmaz wall stent at the level of the pseudoaneurysm and filling of the pseudoaneurysm with multiple Guglielmi detachable coils. Obliteration of the pseudoaneurysm was achieved, and patency of the right internal carotid artery was maintained.ConclusionThe patient's neurological symptoms resolved completely after treatment, and he sustained no neurological complications during the 20-month follow-up period. This case illustrates the successful treatment of a wide-based giant pseudoaneurysm by using a combination of an endovascular stent and coil embolization.

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