Article ID: 11313
The patient was a 71-year-old woman who had previously been diagnosed with neurofibromatosis type 1 (NF-1). She developed dysphagia and hoarseness while under outpatient observation for an asymptomatic extracranial carotid artery aneurysm, with further examinations revealing dilation of the internal carotid artery, for which therapeutic intervention was planned. To determine the optimal treatment, a balloon occlusion test (BOT) was performed, confirming adequate ischemic tolerance. Endovascular trapping of the aneurysm was performed, resulting in a favorable outcome. However, following the treatment, a new dissection of the internal carotid artery occurred at the BOT site, underscoring the vascular vulnerability associated with NF-1. Vascular lesions in NF-1 are thought to arise due to vascular vulnerability resulting from the thinning of the tunica media and the rupture of the elastic lamina. This vulnerability must be considered when selecting approaches for treatment. In this case, coil embolization, both proximal and distal to the aneurysm, prompted thrombosis within the aneurysm and led to early symptomatic improvements.
