Rescue of distally placed stents in the setting of internal carotid artery dissection: A report of 2 cases with mechanistic insights.

Abstract

Potential procedural complications of endovascular therapy for carotid artery dissection have not been clarified. Herein, we present the cases of a 46-year-old woman and a 59-year-old man who underwent carotid artery stenting for left cervical internal carotid artery dissection. During the procedure, intramural hematoma was squeezed out by stent placement, causing further extension of the pseudolumen and a prominent stenosis proximal to the stent. Additional stent deployment was subsequently performed to fully cover the newly arising stenosis, resulting in good recanalization. In cases with a long-affected lesion, we should consider the potential risk of dissection advancement following stent deployment. Using longer stents or additional rescue stenting would be efficient in counteracting this rare complication.

• Authors: Tomohisa Ishida, Hiroyuki Sakata, Masayuki Ezura, Shinichiro Osawa, Atsushi Saito, Teiji Tominaga
• Journal: Clinical neurology and neurosurgery (Clin Neurol Neurosurg) Vol. 214 Pg. 107174 (03 2022) ISSN: 1872-6968 [Electronic] Netherlands
• PMID: 35176636 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 Elsevier B.V. All rights reserved.

Topics

• Carotid Artery, Internal (diagnostic imaging, surgery)
• Carotid Artery, Internal, Dissection (complications, diagnostic imaging, surgery)
• Carotid Stenosis (complications, diagnostic imaging, surgery)
• Constriction, Pathologic
• Female
• Hematoma (complications)
• Humans
• Male
• Middle Aged
• Stents