Emergent Endovascular Treatment of a Spontaneous Internal Carotid Artery Dissection with Pseudoaneurysm

Abstract

Purpose:

To report the use of a coronary stent-graft for the endovascular treatment of a spontaneous internal carotid artery (ICA) dissection complicated by a large pseudoaneurysm.

Case Report:

A 68-year-old man presented to an outside hospital with complaints of headache, severe left-sided neck pain, fever, chills, and vomiting. Contrast-enhanced computed tomography revealed a large (3.5×3 cm) extracranial aneurysm of the left ICA. The patient was emergently transferred to our facility for endovascular treatment of the carotid aneurysm. Via a percutaneous access in the right common femoral artery, 2 Jostent coronary stent-grafts were deployed across the aneurysm with no evidence of a residual pseudoaneurysm. The patient was hemodynamically stable throughout the procedure. Duplex examination at 9 months revealed no evidence of a residual pseudoaneurysm, dissection, or endoleak.

Conclusions:

Covered coronary stents may have a role in the treatment of spontaneous ICA dissection with pseudoaneurysm formation.

Keywords

internal carotid artery dissection pseudoaneurysm stent-graft Jostent Coronary Stent-Graft

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