Logo image
Back
Expanded Endoscopic Endonasal Clipping of a Giant Cavernous Carotid Aneurysm
Journal article   Peer reviewed

Expanded Endoscopic Endonasal Clipping of a Giant Cavernous Carotid Aneurysm

Shravan Atluri, Mario Zanaty, Anthony Guidotti, Ethan Cline, Erin Reilly and Ondrej Choutka
World neurosurgery, Vol.193, 222
01/2025
DOI: 10.1016/j.wneu.2024.11.026
PMID: 39577625

View Online

Abstract

Cavernous Carotid Aneurysms are typically small, asymptomatic, and often do not require treatment. We present the case of a 59-year-old woman, a three-pack-a-day smoker, who presented with the primary complaint of left retro-orbital pain, left complete ophthalmoplegia, left-sided blindness, and right abducens palsy. Imaging revealed a giant right cavernous carotid aneurysm, which had expanded to the contralateral cavernous sinus wall as well as superiorly through the diaphragm sellae. The patient had previously undergone a balloon test occlusion, which was not passed on clinical grounds and resulted in decreased perfusion as well as symptoms of ipsilateral cavernous sinus syndrome and was non adherent to dual anti-platelet therapy. Additionally, the aneurysm had rapidly enlarged over a three-month period, due to these considerations an endonasal approach with clipping and reconstruction was chosen. Patient consent was obtained, and the patient underwent an expanded endoscopic endonasal approach for clipping of a giant cavernous carotid aneurysm with reconstruction of the internal carotid artery. Post-operative CTA confirmed placement of the clips and patency of the vessel. At short term follow up, the patient’s trigeminal pain had successfully resolved and she had retained vision in the right eye. This case demonstrates the feasibility of expanded endonasal approaches in managing this challenging pathology.
 Cavernous Carotid Aneurysm CCA Clipping Endonasal Clipping Endoscopic Clipping Endoscopic Endonasal Approach

Details

Metrics

27 Record Views
Logo image