ABSTRACT
Fenestration of the supraclinoid internal carotid artery is extremely rare and frequently associated with aneurysms at the fenestrated segment or other vascular anomalies. We present a rare case of fenestration of the right supraclinoid internal carotid artery in which a small fenestrated segment arose from the neck portion of the paraclinoid aneurysm and fused with the origin of the posterior communicating artery.
Subject(s)
Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/therapy , Carotid Artery, Internal/abnormalities , Cerebral Arteries/abnormalities , Embolization, Therapeutic/methods , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/therapy , Aged , Angiography, Digital Subtraction , Cerebral Angiography , Diagnosis, Differential , Female , Humans , Imaging, Three-Dimensional , Magnetic Resonance Angiography , Magnetic Resonance ImagingABSTRACT
PURPOSE: To compare shunt patency and clinical outcomes in two groups of patients who received a transjugular intrahepatic portosystemic shunt (TIPS): one group with bare stents and one with expanded polytetrafluoroethylene stent-grafts. MATERIALS AND METHODS: TIPS were created with bare stents (n = 41) or stent-grafts (n = 40). Overall TIPS patency rates were compared between these two groups, as were clinical outcomes in patients with variceal bleeding and those with ascites. RESULTS: In the bare stent group, primary shunt patency rates were 63%, 48%, and 24% at 3, 6, and 12 months, respectively. Secondary patency rates were 75% and 62% at 3 and 6 months, respectively. In the stent-graft group, primary patency rates were 94%, 67%, and 38% at 3, 6, and 12 months, respectively. Secondary patency rates were 100% and 92% at 3 and 6 months, respectively. All stent patency rates were higher in the stent-graft group, but only the difference in the 3-month primary patency rate (63% vs 94%) reached significance (P = .03). In patients with variceal bleeding as well as those with ascites, early and overall clinical success rates were higher in the stent-graft group, but only the 3-month and 12-month differences were statistically significant. CONCLUSIONS: TIPS created with stent-grafts had better 3-month primary patency rates and better 3-month and 12-month clinical success rates compared with those created with bare stents.
