Download PDF
CC BY 4.0 · J Neuroanaesth Crit Care 2023; 10(03): 199-201
DOI: 10.1055/s-0043-1770780
Case Report

Giant ICA Cavernous Aneurysm with Coarctation of Aorta and Autoimmune Hemolytic Disease Posted for Flow Diverter Stenting

Yagna M. Gali 
1   Department of Neuroanaesthesia, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India
,
Moparthi R. Bhushanam
1   Department of Neuroanaesthesia, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India
,
Shekhar R. Gurrala
1   Department of Neuroanaesthesia, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India
,
Sanna R. Reddy
2   Department of Neurosurgery, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India
,
Vipul Pathak
2   Department of Neurosurgery, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Anesthetic management of a case of intracranial aneurysm with coarctation of the aorta poses a formidable challenge to the anesthesiologist. The perioperative risks associated with such cases are rupture of an aneurysm, cardiac arrhythmias, stroke from cerebral insufficiency, intracerebral hemorrhage, myocardial ischemia, thromboembolic stroke, and aortic dissection. Endovascular stenting is preferred over surgical clipping of an aneurysm as flow diverter stenting has less morbidity and mortality compared to the latter, and the parent vessel can also be preserved. Despite the perioperative risks, successful stenting of an internal carotid artery aneurysm is beneficial in preventing impending aneurysm rupture and the progressive worsening of neurological symptoms. Therefore, it is imperative to understand the physiological basis behind the unforeseen complex hemodynamic fluctuations occurring during the procedure, as well as the anesthetic goals and complications encountered during the procedure. We describe and discuss the successful anesthetic management of a case of a giant internal carotid artery aneurysm with coarctation of the aorta and autoimmune hemolytic disease posted for flow diverter stenting.

Keywords

internal carotid artery aneurysm - coarctation of aorta - flow diverter stenting - case report


Publication History

Article published online:
04 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Lonjon M, Pennes F, Sedat J, Bataille B. Epidemiology, genetic, natural history and clinical presentation of giant cerebral aneurysms. Neurochirurgie 2015; 61 (06) 361-365
    CrossrefPubMedSearch in Google Scholar
  • 2 Yu X, Xia L, Jiang Q, Wei Y, Wei X, Cao S. Prevalence of intracranial aneurysm in patients with aortopathy: a systematic review with meta-analyses. J Stroke 2020; 22 (01) 76-86
    CrossrefPubMedSearch in Google Scholar
  • 3 Singh PK, Marzo A, Staicu C. et al. The effects of aortic coarctation on cerebral hemodynamics and its importance in the etiopathogenesis of intracranial aneurysms. J Vasc Interv Neurol 2010; 3 (01) 17-30
    PubMedSearch in Google Scholar
  • 4 Rafieianzab D, Abazari MA, Soltani M, Alimohammadi M. The effect of coarctation degrees on wall shear stress indices. Sci Rep 2021; 11 (01) 12757
    CrossrefPubMedSearch in Google Scholar
  • 5 Cao Q, Zhang J, Xu G. Hemodynamic changes and baroreflex sensitivity associated with carotid endarterectomy and carotid artery stenting. Intervent Neurol 2015; 3 (01) 13-21
    CrossrefPubMedSearch in Google Scholar
  • 6 Webb J, Delaney M. Red blood cell alloimmunization in the pregnant patient. Transfus Med Rev 2018; 32 (04) 213-219
    CrossrefPubMedSearch in Google Scholar