Postoperative evaluation of endovascular parent artery occlusion for the giant extracranial infectious ICA aneurysm: usefulness of transoral carotid ultrasonography (TOCU)

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  • Hagiwara Yuta
    Department of Neurology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • Onodera Hidetaka
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • Uchida Masashi
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • Nakamura Homare
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • Sakakibara Yohtaro
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • Okada Tomoyuki
    Department of Otorhinolaryngology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • Imai Takeshi
    Department of Neurology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • Oshima Jun
    Department of Neurology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • Shimizu Takahiro
    Department of Neurology, St. Marianna University School of Medicine
  • Hasegawa Yasuhiro
    Department of Neurology, St. Marianna University School of Medicine

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Other Title
  • 巨大頭蓋外感染性内頸動脈瘤に対する内頸動脈母血管コイル閉塞術と排膿穿刺術における経口腔頸動脈超音波検査（transoral carotid ultrasonography）の有用性

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A 45-year-old woman was presented to our hospital for severe pharyngalgia and neck pain with fever. The CT angiography revealed the presence of the giant extracranial internal carotid artery (ICA) aneurysm at the time of admission. The MRI revealed abnormal intensity suggestive of abscess formation in the pharyngeal area. Endovascular parent artery occlusion was performed on Day 2. Postoperative evaluation was performed by transoral carotid ultrasonography (TOCU) to obtain image guidance for puncture and drainage the abscess. The ICA and the giant aneurysm were completely thrombosed, and the drainage of abscess was performed with high safety on the basis of the TOCU findings. Although endovascular treatment for extracranial infectious ICA aneurysm has not been well established, our case suggests that the treatment with guidance of TOCU appears effective.

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