Surgical management of giant intrapetrous internal carotid aneurysm presenting with coil exposure after endovascular treatment
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Giant intrapetrous internal carotid aneurysms (petrous ICA aneurysm) are rare. A giant petrous ICA aneurysm presenting with otorrhagia and coil exposure to the external auditory meatus (EAM) after endovascular treatment has never been documented before. The authors report here a case of successful surgical trapping with bypass intervention of a giant petrous ICA aneurysm presenting with coil exposure after endovascular treatment. A 58-year-old man presented with persistent otorrhagia having been admitted to our hospital because of the recurrence of a giant petrous ICA aneurysm after repeated embolization treatments with coils. An electronic otoscope examination demonstrated that a piece of coil escaped into his right EAM. After multidisciplinary consultation, an extracranial-intracranial (EC-IC) bypass with ICA occlusion and coil removal with a closed EAM filling were performed in stages. The patient recovered quickly without any neurological deficits. A digital subtraction angiography confirmed the absence of the aneurysm and patency of the bypass graft.
KeywordsIntrapetrous internal carotid aneurysm Coil escaping Bypass surgery Endovascular coiling
We thank Dr. Yin-Xia (Chief of the Otorhinolaryngology Department, Beijing Tiantan Hospital, Capital Medical University) for general support.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
This report was approved by the patient and the institutional ethical review board of Beijing Tiantan Hospital.
The patient approved the publication of this case presentation.
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