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

Abstract

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.