Embolization of a giant pediatric, posttraumatic, skull base internal carotid artery aneurysm with a liquid embolic agent

Case report

Adam S. Reig, Scott Simon, Robert A. Mericle

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Many treatments for posttraumatic, skull base aneurysms have been described. Eight months after an all-terrain-vehicle accident, this 12-year-old girl presented with right-side Horner syndrome caused by a 33 x 19-mm internal carotid artery aneurysm at the C-1 level. We chose to treat the aneurysm with a new liquid embolic agent for wide-necked, side-wall aneurysms (Onyx HD 500). We felt this treatment would result in less morbidity than surgery and was less likely to occlude the parent artery than placement of a covered stent, especially in a smaller artery in a pediatric patient. Liquid embolic agents also appear to be associated with a lower chance of recanalization and lower cost compared with stent-assisted coil embolization. After the patient was treated with loading doses of aspirin, clopidogrel bisulfate, and heparin, 99% of the aneurysm was embolized with 9 cc of the liquid embolic agent. There were no complications, and the patient remained neurologically stable. Follow-up angiography revealed durable aneurysm occlusion after 1 year. The cost of Onyx was less than the cost of coils required for coil embolization of similarly sized intracranial aneurysms at our institution. Liquid embolic agents can provide a safe, efficacious, and cost-effective approach to treatment of select giant, posttraumatic, skull base aneurysms in pediatric patients.

Original languageEnglish (US)
Pages (from-to)449-452
Number of pages4
JournalJournal of Neurosurgery: Pediatrics
Volume4
Issue number5
DOIs
StatePublished - Nov 1 2009

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Skull Base
Internal Carotid Artery
Aneurysm
Pediatrics
Costs and Cost Analysis
clopidogrel
Stents
Arteries
Off-Road Motor Vehicles
Horner Syndrome
Intracranial Aneurysm
Aspirin
Accidents
Heparin
Angiography
Therapeutics
Morbidity

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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Embolization of a giant pediatric, posttraumatic, skull base internal carotid artery aneurysm with a liquid embolic agent : Case report. / Reig, Adam S.; Simon, Scott; Mericle, Robert A.

In: Journal of Neurosurgery: Pediatrics, Vol. 4, No. 5, 01.11.2009, p. 449-452.

Research output: Contribution to journalArticle

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