{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T21:25:18Z","timestamp":1786829118962,"version":"build-2736575974"},"reference-count":11,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2012,8,21]]},"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>In this case report we describe a successful interdisciplinary approach (including flow redirection and endovascular occlusion) applied to a patient with a continuously growing extracranial giant aneurysm of the right internal carotid artery (ICA) due to known Ehlers\u2013Danlos syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 42-year-old man with a continuously growing extracranial giant aneurysm of the right ICA sought treatment after failed surgery of a similar lesion of the left ICA. A multidisciplinary consultation was held at the end of 2008.<\/jats:p><\/jats:sec><jats:sec><jats:title>Treatment strategy<\/jats:title><jats:p>The treatment strategy consisted of flow redirection in order to secure sufficient cerebral perfusion prior to surgical trapping of the carotid aneurysm. Flow redirection was achieved by placement of a double-barrel extracranial\u2013intracranial bypass. Subsequent surgical trapping failed due to the extreme size of the aneurysm, making certain identification of surrounding structures impossible. The aneurysm was then successfully occluded by neuroradiological intervention. In a further procedure, a large intra-aneurysmal hematoma was surgically removed to reduce the remaining bulging aneurysm sac.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This case report describes a successful interdisciplinary approach for the treatment of a rare giant extracranial ICA aneurysm in a patient with Ehlers\u2013Danlos syndrome. Treatment options for this type are few and carry high risks. Flow redirection via extracranial\u2013intracranial bypass followed by endovascular occlusion appears to be a good treatment approach.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2012-010428","type":"journal-article","created":{"date-parts":[[2012,9,20]],"date-time":"2012-09-20T00:24:13Z","timestamp":1348100653000},"page":"e40-e40","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Double-barrel extracranial\u2013intracranial bypass surgery followed by endovascular carotid artery occlusion in a patient with an extracranial giant internal carotid artery aneurysm due to Ehlers\u2013Danlos syndrome"],"prefix":"10.1136","volume":"5","author":[{"given":"Jason Michael","family":"Perrin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Turowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Jakob","family":"Steiger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"H\u00e4nggi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2012,9,19]]},"reference":[{"key":"2024052223540002000_5.6.e40.1","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1002\/ajmg.a.33231","article-title":"Natural history and manifestations of the hypermobility type Ehlers-Danlos syndrome: a pilot study on 21 patients","volume":"152A","author":"Castori","year":"2010","journal-title":"Am J Med Genet"},{"key":"2024052223540002000_5.6.e40.2","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.adnc.2005.09.006","article-title":"The clinical presentation of Ehlers-Danlos syndrome","volume":"5","author":"Lawrence","year":"2005","journal-title":"Adv Neonatal Care"},{"key":"2024052223540002000_5.6.e40.3","first-page":"73","article-title":"Saccular aneurysms of the extracranial internal carotid artery. 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