A Vision at Risk: Managing a Cavernous Carotid Aneurysm with Flow Diversion

A Vision at Risk: Managing a Cavernous Carotid Aneurysm with Flow Diversion
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Introduction:

Giant intracranial aneurysms, particularly those involving the cavernous segment of the internal carotid artery (ICA), present significant diagnostic and therapeutic challenges due to their size, location, and potential for compressive symptoms. These aneurysms can cause progressive neurological deficits such as visual disturbances, cranial nerve palsies, and headaches due to their mass effect on adjacent neurovascular structures. Conventional surgical options carry high morbidity, especially in deep-seated or complex lesions. Recent advances in endovascular techniques, particularly the use of flow diverter stents, have transformed the management of such lesions by offering a minimally invasive approach that promotes aneurysm thrombosis and vessel wall reconstruction while preserving the parent artery. This case highlights the effectiveness of flow diversion in treating a complex cavernous ICA aneurysm with excellent clinical and radiological outcomes.

CASE:

A Vision at Risk: Managing a Cavernous Carotid Aneurysm with Flow Diversion
A Vision at Risk: Managing a Cavernous Carotid Aneurysm with Flow Diversion
A Vision at Risk: Managing a Cavernous Carotid Aneurysm with Flow Diversion
A Vision at Risk: Managing a Cavernous Carotid Aneurysm with Flow Diversion
A Vision at Risk: Managing a Cavernous Carotid Aneurysm with Flow Diversion

Post-Treatment follow up / Improvement:

  • At 1 Month Post-Stenting:
A Vision at Risk: Managing a Cavernous Carotid Aneurysm with Flow Diversion
  • At 4 Months Post-Stenting:
A Vision at Risk: Managing a Cavernous Carotid Aneurysm with Flow Diversion

Conclusion:

This case demonstrates the critical role of interventional radiology in the management of complex intracranial aneurysms, where traditional surgical approaches may pose significant risk. The use of a flow diverter stent provided a safe and effective treatment strategy, promoting progressive aneurysm thrombosis and remodelling of the parent vessel while minimizing procedural morbidity. The patient experienced complete clinical recovery and marked radiological improvement, highlighting the transformative potential of endovascular techniques. As experience with flow diversion continues to grow, it stands as a cornerstone in the modern management of challenging intracranial aneurysms, reinforcing the value of interventional radiology in delivering precise, minimally invasive, and life-altering care.

DR. VENKATRAMAN KARTHIKEYAN

Dr. Venkatraman Karthikeyan
Consultant Neurologist
Kauvery Hospital, Chennai

DR. SATHYA NARAYANAN R

Dr. Sathya Narayanan R
Consultant Diagnostic and Interventional Radiology
Kauvery Hospital, Chennai

Dr Manish Yadav
Radiology PG
Kauvery Hospital, Chennai