Overlapping stents for treatment of a dissecting carotid artery aneurysm.
OBJECTIVE
To report the increased efficacy of oversized, overlapping stents to treat an internal carotid artery (ICA) dissecting aneurysm.


METHODS
A 55-year-old woman presented with reduced consciousness, aphasia, and right-sided hemiplegia owing to an infarction of the left middle cerebral artery territory documented by computed tomography. Digital subtraction angiography disclosed an extracranial dissection of the left ICA with a pseudoaneurysm. Two self-expanding Wallstents were placed, bridging the dissected segment and overlapping at the level of the aneurysm neck. Immediate arteriography showed remarkably reduced filling of the pseudoaneurysm. Serial arteriograms performed 6 days and 9 and 20 months after stenting documented the disappearance of the pseudoaneurysm without appreciable intimal hyperplasia of the vessel w all.


CONCLUSIONS
Reducing stent porosity by overlapping the devices causes significant hemodynamic changes inside the aneurysm sac, accelerating intra-aneurysmal thrombosis.
Benndorf
G
G
Department of Radiology, Charité, Humboldt University, Berlin, Germany. g.benndorf@charite.de
Campi
A
A
Schneider
G H
GH
Wellnhofer
E
E
Unterberg
A
A
D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002544:Cerebral Infarction / Q000209:etiology; D005260:Female; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D015607:Stents