Efficacy of pipeline endovascular device and Willis stent graft in the treatment of traumatic pseudo intracranial aneurysms

Objective: To investigate the advantages and effects of pipeline embolization device（PED） or Willis stent, in treating traumatic pseudoaneurysms. Traumatic pseudo intracranial aneurysms（TPIA） can be caused by either direct trauma or iatrogenic injuries, usually caused by direct arterial wall injury or shear due to acceleration. We describe a series of patients with TPIA who received a PED or Willis stent.Materials and methods: Retrospective analysis was performed on nine patients with TPIA admitted to the southern hospital of Southern Medical University from December 2017 to June 2019, of whom four were treated with PED and five were implanted with six Willis covered stents. The occlusive rate and complication in the two kinds of stents were compared by postoperative follow-up and modified rankin score（MRS）.Results: After the implantation of PED, four patients showed an immediate stagnation of blood flow or a decreased filling in aneurysms, three out of four patients exhibited complete occlusion, and the remaining patient had nearly complete occlusion. Four out of five cases of Willis stent implantation were associated with immediate complete occlusion of aneurysms, and the modified rankin score of these patients ranged from 0 to 1. One patient died of unassociated complications.Conclusion: For different types of TPIA in the internal carotid artery（ICA）, PED and Willis stents provide significant advantages in treatment, with fewer postoperative complications and prognosis well.