SUCCESSFUL MANAGEMENT OF TRAUMATIC FALSE ANEURYSM OF THE EXTRACRANIALVERTEBRAL ARTERY BY DUPLEX-DIRECTED MANUAL OCCLUSION - A CASE-REPORT

A 32-year-old man was transferred to our hospital after a 2.0 by 2.5 c m traumatic false aneurysm of the distal extracranial vertebral artery was noted after a stab wound of the posterior side of the neck. To ob viate the need for operative exposure of the distal vertebral artery a t the base of the skull, we elected to perform duplex-directed manual occlusion of the lesion. Angiography before and after the procedure, a s well as 10-month follow-up duplex ultrasonography, demonstrated sati sfactory thrombosis of the false aneurysm without evidence of a residu al arterial defect. There was no morbidity associated with the procedu re. We conclude that duplex-directed manual occlusion, a new technique recently described for the nonoperative management of postcatheteriza tion femoral false aneurysms, can be applied safely and effectively to false aneurysms in other locations in which the risks and technical d ifficulties of operative repair render surgery less desirable.