Spontaneous Dissecting Pseudoaneurysm of the Extracranial Internal Carotid Artery: Endovascular Treatment with a Palmaz Stent

Abstract

This case illustrates the usefulness of an endovascular stent to treat a pseudoaneurysm of the cervical internal carotid artery. A 46-year-old male patient presented with a spontaneous dissection of the cervical internal carotid artery. After failing conservative therapy, he was treated by endovascular placement of a Palmaz stent at level of the pseudoaneurysm and dissection.

Immediate obliteration of pseudoaneurysm was achieved, and patency of the internal carotid artery was maintained. The patient sustained no neurological complications and the stenosis of treated carotid artery did not occur during the 6-month follow-up period.

For internal carotid artery dissection, stent placement seems to be a reasonable therapeutic alternative to direct surgery.

Keywords

dissecting aneurysm carotid artery stent

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References

Schievink

Mokri

: Internal carotid artery dissection in a community. Rochester, Minnesota, 1987–1992. Stroke 24: 1678–1680, 1993.

Chaikof

Smith

III : Management of extracranial carotid artery fibromuscular disease and spontaneous dissection. In: Callogaro

DeLaurentis

Baker

(eds): Management of extracranial cerebrovascular disease. Lippincott-Raven, Philadelphia 1997: 173–182.

Pitner

: Carotid thrombosis due to intraoral trauma. An unusual complication of a common childhood accident. N Engl J Med 274: 764–767, 1966.

Sen

Sekhar

: Direct vein graft reconstruction of cavernous, petrous, and upper cervical internal carotid artery: Lessons learned from 30 cases. Neurosurgery 30: 732–743, 1992.

Perez-Cruel

Patwardhan

: Treatment of dissecting psedoaneurysm of the cervical internal carotid artery using a wall stent and detachable coils: Case report. Neurosurgery 40: 622–626, 1997.

Eckard

Lee

: The implications of stents and cyanoacrylates for the treatment of cerebrovascular disease. In: MacIunas (ed): Neurosurgical topics series. Endovascular neurological intervention. AANS, Illinois 1995: 159–177.

Klein

Szolar

: Post-traumatic extracranial aneurysm of the internal carotid artery: Combined endovascular treatment with coils and stents. Am J Neuroradiol 18: 1261–1264, 1997.

Manninen

Koivisto

: Dissecting aneurysms of all four cervicocranial arteries in fibromuscular dysplasia: Treatment with self-expanding endovascular stents, coil embolization, and surgical ligation. Am J Neuroradiol 18: 1216–1220, 1997.

Marks

Dake

: Stent placement for arterial and venous cerebrovascular disease: Preliminary experience. Radiology 191: 441–446, 1994.

10.

Mase

Banno

: Endovascular stent placement for multiple aneurysms of the extracranial internal carotid artery: Technical case report. Neurosurgery 37: 832–835, 1995.

11.

Miyachi

Ishiguchi

: Endovascular Stenting for Pseudoaneurysms of the cervical carolid artery. Interventional Neuroradiology 3 (Suppl 2): 129–132, 1997.

12.

Theron

Payelle

: Carotid artery stenosis: Treatment with proctected balloon angioplasty and stent placement. Radiology 201: 627–636, 1996.

13.

Diethrich

Ndiaye

: Stenting in the carotid artery: Initial experience in 110 patients. J Endovasc Surg 3: 42–62, 1996.

14.

Rosenfield

Schainfeld

: Restenosis of endovascular stents from stent compression. J Am Coll Cardiol 29: 328–338, 1997.

15.

Crissey

Bernstein

: Delayed presentation of carotid intimal tear following blunt craniocervical trauma. Surgery 75: 543–549, 1974.